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
For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durom
LARGO, FL
Negotiated rates from the hospital’s own file: 7 payers, 11 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 | Humana tricare fee schedule · outpatient | $54 | $54 | — | — | — | $54 – $54 |
| 2 | Caresource tricare fee schedule · outpatient | $55 | $55 | — | — | — | $55 – $55 |
| 3 | Devoted mcr fee schedule · outpatient | $55 | $55 | — | — | — | $55 – $55 |
| 4 | UnitedHealthcare mgmcd fee schedule · outpatient | $55 | $55 | — | — | — | $55 – $55 |
| 5 | Blue Cross Blue Shield mcrppo fee schedule · outpatient | $56 | $56 | — | — | — | $56 – $56 |
| 6 | Blue Cross Blue Shield mgmcrhmo fee schedule · outpatient | $56 | $56 | — | — | — | $56 – $56 |
| 7 | UnitedHealthcare mcr fee schedule · outpatient | $56 | $56 | — | — | — | $56 – $56 |
| 8 | Humana mgmcrppo fee schedule · outpatient | $58 | $58 | — | — | — | $58 – $58 |
| 9 | WellCare mcr fee schedule · outpatient | $58 | $58 | — | — | — | $58 – $58 |
| 10 | Cigna Healthspring mcr fee schedule · outpatient | $59 | $59 | — | — | — | $59 – $59 |
| 11 | Humana mgmcrhmo fee schedule · outpatient | $61 | $61 | — | — | — | $61 – $61 |