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South Carolina rates for HCPCS L3250

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

Facilitymedian $141 · 10th–90th $105–$3630%20%10th90th$141Professionalmedian $132 · 10th–90th $105–$2140%10%10th90th$132$50.0$100.0$200.0$500.0$1.0K

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
$104.71 / $104.71 / $104.71
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $128.82 / $208.93
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $229.09 / $295.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $208.93 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $218.78
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $154.88 / $398.11
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $109.65
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $165.96 / $223.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $131.83 / $213.80