Custom molded plastazote 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 L3253 115X-150

Henderson, NV

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Pricing by billing methodology

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How this price compares nationally

Dignity Health’s median price of $403 is 447% above the median hospital's median price ($74), higher than 96% of the 355 hospitals reporting HCPCS L3253. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS L3253 at Dignity Health

Negotiated rates from the hospital’s own file: 5 payers, 15 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 commercial\|dh employees fee schedule · inpatient	$276	$276	$37	13%	—	$240 – $313
2	UnitedHealthcare commercial\|dh employees fee schedule · outpatient	$276	$276	$37	13%	—	$240 – $313
3	Aetna commercial\|hmo fee schedule · inpatient	$304	$304	$40	13%	—	$264 – $344
4	Aetna commercial\|all other plans fee schedule · inpatient	$313	$313	$41	13%	—	$272 – $355
5	Aetna commercial\|ppo fee schedule · inpatient	$313	$313	$41	13%	—	$272 – $355
6	Anthem commercial\|hmo fee schedule · inpatient	$322	$322	$43	13%	—	$280 – $365
7	Anthem commercial\|ppo fee schedule · inpatient	$414	$414	$55	13%	—	$360 – $469
8	Cigna commercial\|all other plans fee schedule · inpatient	$571	$571	$76	13%	—	$495 – $647
9	Cigna commercial\|all other plans fee schedule · outpatient	$571	$571	$76	13%	—	$495 – $647
10	Cigna commercial\|ppo fee schedule · inpatient	$571	$571	$76	13%	—	$495 – $647
11	Cigna commercial\|ppo fee schedule · outpatient	$571	$571	$76	13%	—	$495 – $647
12	MultiPlan commercial\|all plans fee schedule · inpatient	$635	$635	$84	13%	—	$551 – $720
13	MultiPlan commercial\|all plans fee schedule · outpatient	$635	$635	$84	13%	—	$551 – $720
14	UnitedHealthcare commercial\|options fee schedule · inpatient	$663	$663	$88	13%	—	$575 – $751
15	UnitedHealthcare commercial\|options fee schedule · outpatient	$663	$663	$88	13%	—	$575 – $751

Last updated: Feb 28, 2026

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