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Washington rates for HCPCS L3201

Orthopedic shoe, Oxford with supinator or pronator, infant

Facilitymedian $65 · 10th–90th $35–$930%10%20%10th90th$65Professionalmedian $33 · 10th–90th $18–$850%10%10th90th$33$0.5$2.0$10.0$50.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $85.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $25.70 / $38.02
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $52.48 / $104.71
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $21.88 / $30.20
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $75.86 / $109.65
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $75.86 / $102.33
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $50.12 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $58.88 / $70.79
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $48.98 / $48.98
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $66.07 / $93.33
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $52.48 / $114.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.20 / $23.44 / $30.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $25.12 / $38.90
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $38.02 / $67.61