Custom molded plastazote shoe insert

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Shoe molded plastazote cust

Payers reporting HCPCS L3253

Payer pricing summary

Low

Average

$220

Median

$156

High

$797

Payer rate distribution

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Filter by billing class

#
1	Humana fee schedule · outpatient · +9 other terms	50	$217	$220	$147	67%	—	$15 – $846
2	Blue Cross Blue Shield facility · fee schedule · outpatient · +11 other terms	36	$186	$208	$120	58%	—	$50 – $572
3	UnitedHealthcare fee schedule · both · +12 other terms	27	$18	$34	$21	61%	—	$18 – $84
4	Aetna fee schedule · outpatient · +12 other terms	24	$21	$308	$325	105%	—	$15 – $836
5	Anthem facility · case rate · outpatient · +8 other terms	15	$29	$31	$7	23%	—	$20 – $49
6	Caresource facility · case rate · outpatient · +2 other terms	15	$29	$31	$7	23%	—	$20 – $50
7	Cigna fee schedule · both · +9 other terms	15	$70	$64	$11	18%	—	$36 – $70
8	Molina facility · case rate · outpatient · +5 other terms	15	$29	$31	$7	23%	—	$20 – $49
9	Wellmark fee schedule · both · +2 other terms	13	$217	$212	$27	13%	—	$50 – $217
10	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$589	$443	$252	57%	—	$186 – $737
11	Regence fee schedule · outpatient · +1 other terms	12	$34	$37	$10	26%	—	$27 – $89
12	Optum facility · case rate · outpatient · +4 other terms	11	$27	$30	$7	22%	—	$24 – $44
13	Highmark fee schedule · outpatient · +1 other terms	10	$60	$60	—	—	—	$60 – $60
14	Medica fee schedule · outpatient · +4 other terms	10	$61	$61	$16	26%	—	$37 – $79
15	MultiPlan fee schedule · outpatient · +10 other terms	10	$583	$572	$165	29%	—	$82 – $797
16	Ucare fee schedule · both · +3 other terms	9	$202	$202	—	—	—	$202 – $202
17	Healthcare Highways percent of total billed charges · outpatientfrom % of charges	8	$352	$363	$95	26%	—	$215 – $570
18	Superior Healthplan percent of total billed charges · outpatientfrom % of charges	8	$73	$80	$24	30%	—	$45 – $118
19	Aetna Better Health fee schedule · inpatient · +2 other terms	7	$16	$16	—	—	—	$16 – $16
20	First Health fee schedule · outpatient · +5 other terms	4	$434	$410	$101	25%	—	$204 – $525
21	Kaiser fee schedule · inpatient · +4 other terms	4	$391	$361	$111	31%	—	$173 – $525
22	WellCare fee schedule · outpatient · +1 other terms	4	$168	$162	$89	55%	—	$30 – $282
23	Bcbs Ks fee schedule · outpatient · +1 other terms	3	$166	$172	$10	6%	—	$165 – $187
24	Medcost fee schedule · outpatient · +3 other terms	3	$793	$790	$41	5%	—	$741 – $833
25	Oscar facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	3	$473	$363	$155	43%	—	$143 – $473

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