Orthopedic shoe leather insole

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

Ortho shoe add leather insol

Payers reporting HCPCS L3500

Payer pricing summary

Low

Average

$43

Median

$38

High

$99

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +9 other terms	358	$36	$42	$19	46%	—	$18 – $235
2	UnitedHealthcare fee schedule · outpatient · +9 other terms	355	$36	$36	$9	23%	—	$4 – $116
3	Humana fee schedule · outpatient · +9 other terms	316	$36	$54	$58	108%	—	$18 – $278
4	Blue Cross Blue Shield fee schedule · outpatient · +7 other terms	216	$37	$47	$24	52%	—	$0 – $173
5	WellCare fee schedule · outpatient · +4 other terms	208	$37	$38	$6	15%	—	$34 – $68
6	Devoted fee schedule · outpatient · +3 other terms	165	$36	$36	$1	2%	—	$35 – $44
7	Molina fee schedule · outpatient · +4 other terms	137	$51	$50	$19	37%	—	$27 – $95
8	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$37	$37	$1	3%	—	$36 – $44
9	Cigna fee schedule · outpatient · +6 other terms	102	$37	$41	$11	27%	—	$35 – $105
10	Anthem fee schedule · outpatient · +6 other terms	80	$36	$49	$47	96%	—	$34 – $269
11	Kaiser fee schedule · outpatient · +4 other terms	64	$37	$58	$40	70%	—	$35 – $258
12	Superior Healthplan fee schedule · outpatient	40	$38	$38	$0	0%	—	$35 – $38
13	Clover fee schedule · outpatient · +2 other terms	37	$36	$36	$2	5%	—	$34 – $43
14	Oscar fee schedule · outpatient · +3 other terms	36	$38	$42	$9	21%	—	$35 – $61
15	Ambetter facility · fee schedule · outpatient · +5 other terms	33	$65	$68	$16	24%	—	$34 – $90
16	Optum fee schedule · outpatient · +2 other terms	33	$36	$47	$19	41%	—	$35 – $90
17	Caresource fee schedule · outpatient · +4 other terms	26	$36	$41	$8	20%	—	$36 – $56
18	Medica facility · fee schedule · outpatient · +5 other terms	22	$37	$34	$9	26%	—	$12 – $60
19	Regence facility · fee schedule · outpatient · +3 other terms	19	$38	$36	$3	8%	—	$29 – $38
20	Amerihealth Caritas fee schedule · outpatient · +1 other terms	18	$43	$42	$2	6%	—	$36 – $43
21	Bcbs Tx fee schedule · outpatient	18	$35	$35	—	—	—	$35 – $35
22	Medicare fee schedule · outpatient · +1 other terms	18	$35	$35	$0	1%	—	$35 – $36
23	Medical Mutual facility · fee schedule · outpatient · +1 other terms	15	$36	$41	$10	25%	—	$20 – $57
24	Bcbs Mn fee schedule · outpatient · +6 other terms	13	$33	$33	$8	23%	—	$16 – $38
25	Wellmark fee schedule · both · +1 other terms	13	$33	$33	$1	3%	—	$26 – $33

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