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.
Original text from hospital filings
Shoe molded plastazote cust
Low
$14
Average
$182
Median
$73
High
$1.0k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
113 hospitals; the 90th percentile is 35.7× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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123 hospital rates
iThe hospitals that file a Aetna rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · percent of total billed charges · bothfrom % of charges | 2 | $347 | $347 | $50 | 14% | — | $298 – $397 |
| 2 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · percent of total billed charges · outpatientfrom % of charges | 4 | $258 | $220 | $79 | 36% | — | $87 – $278 |
| 3 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 4 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 2 | $74 | $74 | $1 | 1% | — | $74 – $75 |
| 5 | Alta Newport Hospital, LLC Tustin, CA facility · case rate · outpatient | 2 | $73 | $73 | — | — | — | $73 – $73 |
| 6 | Berger Hospital Circleville, OH fee schedule · outpatient | 1 | $46 | $46 | — | — | — | $46 – $46 |
| 7 | Bethesda Hospital Inc. Lebanon, OH facility · fee schedule · outpatient | 1 | $42 | $42 | $0 | 1% | — | $41 – $42 |
| 8 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 9 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 2 | $17 | $22 | $7 | 32% | — | $17 – $32 |
| 10 | Broaddus Hospital Association Inc Philippi, WV professional · fee schedule · both | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 11 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $41 | $41 | — | — | — | $41 – $41 |
| 12 | CHI St. Vincent Hospital Hot Springs Hot Springs, AR fee schedule · inpatient | 3 | $82 | $82 | — | — | — | $82 – $82 |
| 13 | CHI St. Vincent Hospital Hot Springs Hot Springs, AR fee schedule · outpatient | 3 | $82 | $82 | — | — | — | $82 – $82 |
| 14 | CHRISTUS Good Shepherd Hospital - Northpark Longview, TX fee schedule · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 15 | COMMUNITY HOSPITAL OF SAN BERNARDINO San Bernardino, CA fee schedule · inpatient | 2 | $259 | $262 | $42 | 16% | — | $207 – $323 |
| 16 | Centennial Hills Las Vegas, NV percent of total billed charges · bothfrom % of charges | 2 | $507 | $507 | $189 | 37% | — | $318 – $696 |
| 17 | Central Iowa Hospital Corporation Des Moines, IA fee schedule · both | 2 | $74 | $74 | — | — | — | $74 – $74 |
| 18 | Central Iowa Hospital Corporation West Des Moines, IA fee schedule · both | 2 | $74 | $74 | — | — | — | $74 – $74 |
| 19 | Charles A. Dean Memorial Hospital Greenville, ME professional · fee schedule · outpatient | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 20 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 2 | $23 | $23 | — | — | — | $23 – $23 |
| 21 | Clarion Hospital Clarion, PA facility · fee schedule · outpatient | 1 | $43 | $43 | — | — | — | $43 – $43 |
| 22 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · fee schedule · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 23 | Clinton Memorial Hospital Wilmington, OH fee schedule · outpatient | 1 | $42 | $42 | $0 | 1% | — | $41 – $42 |
| 24 | Conway Hospital, Inc. Conway, SC professional · fee schedule · outpatient | 1 | $973 | $973 | — | — | — | $973 – $973 |
| 25 | Covenant Medical Center Lubbock, TX fee schedule · outpatient | 1 | $63 | $63 | — | — | — | $63 – $63 |
← Payers reporting HCPCS L3253 · Snapshot 20261112T181611Z-3fa9fb76