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Texas rates for HCPCS L3250

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

Facilitymedian $229 · 10th–90th $112–$1,4450%10%20%10th90th$229Professionalmedian $123 · 10th–90th $85–$2000%20%40%10th90th$123$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
$120.23 / $120.23 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $123.03 / $186.21
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,388.44 / $4,168.69
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
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
$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
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $239.88 / $380.19
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $123.03 / $186.21
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $107.15 / $112.20
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $239.88 / $380.19
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $208.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $141.25 / $199.53
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $141.25 / $263.03
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $181.97