Metatarsal bar wedge shoe insert at Dignity Health

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 L3400 30X-39

Carmichael, CA

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Pricing by billing methodology

Price type

How this price compares nationally

Dignity Health’s median price of $109 is 113% above the median hospital's median price ($51), higher than 94% of the 857 hospitals reporting HCPCS L3400. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS L3400 at Dignity Health

Negotiated rates from the hospital’s own file: 9 payers, 36 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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#
1	UnitedHealthcare medicaid\|< 21 fee schedule · outpatient	$9	$9	—	—	—	$9 – $9
2	UnitedHealthcare medicaid\|> 21 fee schedule · outpatient	$9	$9	—	—	—	$9 – $9
3	Molina medicaid\|all plans fee schedule · outpatient	$12	$12	—	—	—	$12 – $12
4	Anthem medicaid\|all plans fee schedule · outpatient	$17	$17	—	—	—	$17 – $17
5	Kaiser commercial\|all plans fee schedule · inpatient	$45	$45	—	—	—	$45 – $45
6	Kaiser medicaid\|all plans fee schedule · inpatient	$45	$45	—	—	—	$45 – $45
7	Kaiser medicare\|all plans fee schedule · inpatient	$45	$45	—	—	—	$45 – $45
8	Anthem medicaid\|all plans fee schedule · inpatient	$47	$47	—	—	—	$47 – $47
9	Molina medicaid\|all plans fee schedule · inpatient	$51	$51	—	—	—	$51 – $51
10	Cigna commercial\|localplus fee schedule · inpatient	$78	$78	—	—	—	$78 – $78
11	Kaiser medicaid\|all plans fee schedule · outpatient	$80	$80	—	—	—	$80 – $80
12	UnitedHealthcare commercial\|non-options ppo fee schedule · outpatient	$101	$101	—	—	—	$101 – $101
13	Cigna commercial\|all other plans fee schedule · inpatient	$103	$103	—	—	—	$103 – $103
14	Kaiser commercial\|all plans fee schedule · outpatient	$105	$105	—	—	—	$105 – $105
15	Cigna commercial\|localplus fee schedule · outpatient	$107	$107	—	—	—	$107 – $107
16	UnitedHealthcare commercial\|all other plans fee schedule · outpatient	$109	$109	—	—	—	$109 – $109
17	UnitedHealthcare commercial\|hmo fee schedule · outpatient	$109	$109	—	—	—	$109 – $109
18	UnitedHealthcare commercial\|options ppo fee schedule · outpatient	$109	$109	—	—	—	$109 – $109
19	Blue Cross Blue Shield commercial\|aco trio fee schedule · inpatient	$127	$127	—	—	—	$127 – $127
20	Cigna commercial\|all other plans fee schedule · outpatient	$144	$144	—	—	—	$144 – $144
21	First Health commercial\|all plans fee schedule · inpatient	$146	$146	—	—	—	$146 – $146
22	First Health commercial\|all plans fee schedule · outpatient	$146	$146	—	—	—	$146 – $146
23	Anthem commercial\|connection epo fee schedule · outpatient	$152	$152	—	—	—	$152 – $152
24	Blue Cross Blue Shield commercial\|aco trio calpers fee schedule · inpatient	$160	$160	—	—	—	$160 – $160
25	Blue Cross Blue Shield commercial\|exchange fee schedule · inpatient	$160	$160	—	—	—	$160 – $160

Page 1 of 2 · 36 rates

Last updated: Feb 28, 2026

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