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Tennessee rates for HCPCS L3250

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

Facilitymedian $209 · 10th–90th $120–$1,4450%20%10th90th$209Professionalmedian $126 · 10th–90th $107–$2090%20%40%10th90th$126$0.2$1.0$5.0$20.0$100.0$500.0

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
$109.65 / $120.23 / $194.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $123.03 / $208.93
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $316.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $208.93
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,445.44 / $1,445.44
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,862.09 / $1,862.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $144.54 / $229.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $128.82 / $218.78