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.
Original text from hospital filings
O shoe add instep extension
Maple Grove, MN
See all hospitals reporting HCPCS L3570 →Price type
Fairview Maple Grove Surgery Center’s median price of $116 is 8% above the median hospital's median price ($107), higher than 73% of the 822 hospitals reporting HCPCS L3570. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 5 payers, 22 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 | Blue Cross Blue Shield federal fee schedule · outpatient | $88 | $88 | — | — | — | $88 – $88 |
| 2 | Blue Cross Blue Shield commercial fee schedule · outpatient | $90 | $90 | — | — | — | $90 – $90 |
| 3 | Blue Cross Blue Shield medicaid fee schedule · outpatient | $90 | $90 | — | — | — | $90 – $90 |
| 4 | Blue Cross Blue Shield federal fee schedule · both | $95 | $95 | — | — | — | $95 – $95 |
| 5 | Blue Cross Blue Shield commercial fee schedule · both | $97 | $97 | — | — | — | $97 – $97 |
| 6 | Medica accessability fee schedule · both | $100 | $100 | — | — | — | $100 – $100 |
| 7 | Medica medicaid fee schedule · both | $100 | $100 | — | — | — | $100 – $100 |
| 8 | Medica ma non-snp fee schedule · both | $109 | $109 | — | — | — | $109 – $109 |
| 9 | Medica ma snp fee schedule · both | $109 | $109 | — | — | — | $109 – $109 |
| 10 | Medica prime solution fee schedule · both | $109 | $109 | — | — | — | $109 – $109 |
| 11 | Medica vantage fee schedule · both | $109 | $109 | — | — | — | $109 – $109 |
| 12 | Blue Cross Blue Shield medicaid fee schedule · both | $109 | $109 | — | — | — | $109 – $109 |
| 13 | Ucare mhcp fee schedule · both | $112 | $112 | — | — | — | $112 – $112 |
| 14 | Cigna commercial fee schedule · both | $134 | $134 | $12 | 9% | — | $123 – $146 |
| 15 | Ucare ifp with fairview fee schedule · outpatient | $181 | $181 | — | — | — | $181 – $181 |
| 16 | Medica bold fee schedule · both | $189 | $189 | — | — | — | $189 – $189 |
| 17 | UnitedHealthcare commercial fee schedule · both | $196 | $196 | — | — | — | $196 – $196 |
| 18 | Medica choice without / elect fee schedule · both | $210 | $210 | — | — | — | $210 – $210 |
| 19 | Medica city of st paul / essential uplan fee schedule · both | $210 | $210 | — | — | — | $210 – $210 |
| 20 | Medica choice with fee schedule · both | $217 | $217 | — | — | — | $217 – $217 |
| 21 | Ucare ifp fee schedule · outpatient | $241 | $241 | — | — | — | $241 – $241 |
| 22 | Cigna commercial fee schedule · outpatient | $282 | $282 | $25 | 9% | — | $258 – $307 |
Last updated: May 18, 2026
See Leather orthopedic shoe instep extension pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.