Repair or replacement of minor orthotic device parts

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

Pad Replacement Miami J Adult

Payers reporting HCPCS L4210

Payer pricing summary

Low

Average

$98

Median

$61

High

$933

Payer rate distribution

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#
1	Blue Cross Blue Shield facility · fee schedule · outpatient · +18 other terms	41	$49	$192	$157	82%	—	$14 – $830
2	Aetna fee schedule · outpatient · +18 other terms	29	$22	$45	$35	79%	—	$14 – $142
3	UnitedHealthcare facility · case rate · outpatient · +18 other terms	23	$15	$11	$9	76%	—	$0 – $27
4	Ucare facility · percent of total billed charges · bothfrom % of charges · +4 other terms	17	$35	$36	$20	56%	—	$7 – $75
5	Medcost professional · percent of total billed charges · outpatientfrom % of charges · +2 other terms	16	$71	$87	$27	31%	—	$48 – $135
6	Medical Mutual professional · percent of total billed charges · outpatientfrom % of charges · +1 other terms	16	$71	$89	$29	32%	—	$48 – $135
7	Anthem facility · case rate · outpatient · +16 other terms	15	$15	$17	$4	23%	—	$10 – $26
8	Caresource facility · case rate · outpatient · +6 other terms	15	$16	$17	$4	22%	—	$10 – $27
9	Molina facility · case rate · outpatient · +10 other terms	15	$15	$17	$4	22%	—	$11 – $26
10	Aetna Better Health fee schedule · outpatient · +5 other terms	13	$21	$155	$145	94%	—	$21 – $312
11	Wellmark fee schedule · both · +4 other terms	13	$16	$20	$21	107%	—	$16 – $150
12	Baylor Scott White Health Plan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	12	$16	$16	$1	8%	—	$15 – $17
13	Bcbs Mn fee schedule · outpatient · +6 other terms	12	$55	$38	$23	60%	—	$18 – $69
14	Superior Healthplan facility · percent of total billed charges · outpatientfrom % of charges · +2 other terms	12	$6	$6	$2	31%	—	$4 – $10
15	Optum facility · case rate · outpatient · +7 other terms	11	$14	$16	$3	21%	—	$13 – $24
16	Cigna professional · fee schedule · outpatient · +16 other terms	10	$118	$106	$25	24%	—	$50 – $118
17	Beechstreet percent of total billed charges · bothfrom % of charges	9	$74	$74	$4	5%	—	$70 – $81
18	Healthcare Highways percent of total billed charges · outpatientfrom % of charges · +2 other terms	9	$78	$116	$54	47%	—	$61 – $205
19	Regence percent of total billed charges · outpatientfrom % of charges · +2 other terms	9	$34	$49	$49	100%	—	$32 – $225
20	Premera percent of total billed charges · outpatientfrom % of charges · +1 other terms	8	$40	$39	$1	4%	—	$36 – $40
21	Medicaid fee schedule · outpatient · +5 other terms	7	$46	$46	$1	2%	—	$46 – $49
22	Humana case rate · inpatient · +14 other terms	6	$19	$19	$0	2%	—	$19 – $19
23	Medica per diem · inpatient · +9 other terms	5	$19	$19	$0	2%	—	$19 – $19
24	Ambetter other · both · +4 other terms	4	$0	$0	—	—	—	$0 – $0
25	Healthpartners facility · other · outpatient · +5 other terms	4	$180	$180	—	—	—	$180 – $180

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