Non-standard size orthotic foot brace

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

Orth foot non-stndard size/w

Payers reporting HCPCS L3254

Payer pricing summary

Low

Average

$46

Median

$32

High

$164

Payer rate distribution

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#
1	Blue Cross Blue Shield facility · fee schedule · outpatient · +7 other terms	37	$34	$76	$65	86%	—	$0 – $234
2	Aetna fee schedule · outpatient · +8 other terms	21	$14	$33	$23	70%	—	$14 – $90
3	Anthem facility · case rate · outpatient · +6 other terms	15	$15	$17	$4	23%	—	$10 – $26
4	Caresource facility · case rate · outpatient · +1 other terms	15	$16	$17	$4	23%	—	$10 – $27
5	Molina facility · case rate · outpatient · +4 other terms	15	$15	$17	$4	23%	—	$11 – $26
6	UnitedHealthcare facility · case rate · outpatient · +5 other terms	15	$16	$17	$4	23%	—	$11 – $27
7	Wellmark fee schedule · both · +1 other terms	13	$47	$46	$2	4%	—	$35 – $47
8	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$50	$37	$21	57%	—	$16 – $62
9	Clover facility · percent of total billed charges · outpatientfrom % of charges	12	$8	$8	$2	30%	—	$0 – $8
10	Optum facility · case rate · outpatient · +1 other terms	11	$14	$16	$4	22%	—	$13 – $24
11	Cigna professional · fee schedule · outpatient · +6 other terms	10	$8	$9	$3	35%	—	$8 – $17
12	Highmark fee schedule · outpatient · +1 other terms	10	$2	$2	—	—	—	$2 – $2
13	Aetna Better Health fee schedule · inpatient · +1 other terms	7	$14	$14	—	—	—	$14 – $14
14	Humana fee schedule · inpatient · +3 other terms	5	$14	$14	—	—	—	$14 – $14
15	Kaiser fee schedule · inpatient · +1 other terms	4	$150	$139	$38	28%	—	$77 – $179
16	MultiPlan fee schedule · inpatient · +5 other terms	4	$204	$204	—	—	—	$204 – $204
17	Bcbs Ks fee schedule · outpatient · +1 other terms	3	$166	$172	$10	6%	—	$165 – $187
18	First Health fee schedule · inpatient · +2 other terms	3	$168	$171	$6	3%	—	$166 – $179
19	WellCare facility · percent of total billed charges · outpatientfrom % of charges	3	$21	$21	—	—	—	$21 – $21
20	Excellus fee schedule · outpatient	2	$8	$9	$20	218%	—	$2 – $65
21	Bcbs Il professional · fee schedule · both	1	$35	$35	—	—	—	$35 – $35
22	Bcbs La facility · fee schedule · outpatient	1	$0	$0	—	—	—	$0 – $0
23	Bcbs Nc facility · fee schedule · outpatient	1	$17	$17	$8	49%	—	$5 – $23
24	Bcbs Nv fee schedule · outpatient	1	$14	$14	—	—	—	$14 – $14
25	Bcbs Vt professional · fee schedule · outpatient	1	$29	$29	—	—	—	$29 – $29

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