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Michigan rates for HCPCS L3250

Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each

Facilitymedian $525 · 10th–90th $123–$1,7380%10%20%10th90th$525Professionalmedian $141 · 10th–90th $110–$3800%20%10th90th$141$0.2$1.0$5.0$20.0$100.0$500.0$2.0K

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
$123.03 / $123.03 / $123.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $123.03 / $208.93
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $1,148.15 / $2,187.76
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $380.19 / $398.11
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $204.17
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $154.88 / $371.54
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $562.34 / $630.96
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $218.78 / $302.00
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $338.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.40 / $141.25 / $190.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $141.25 / $245.47