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Foot, Molded Shoe, Plastazote, Custom Fitted

Hawaii rates for HCPCS L3253

Foot, molded shoe, Plastazote (or similar), custom fitted, each

Rates data updated July 2026.

Facilitymedian $50 · 10th–90th $19$550%50%10th90th$50Professionalmedian $85 · 10th–90th $17$890%50%10th90th$85$10.0$20.0$50.0$100.0

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

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$16.98
Median
$16.98
Typical High
$18.62
Cigna
Setting
Facility
Modifier
Global
Typical Low
$37.15
Median
$54.95
Typical High
$54.95
Cigna
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$54.95
HMSA
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$89.13
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$8.51
Median
$8.51
Typical High
$8.51
United
Setting
Facility
Modifier
Global
Typical Low
$19.50
Median
$24.55
Typical High
$51.29
United
Setting
Professional
Modifier
Global
Typical Low
$17.38
Median
$29.51
Typical High
$56.23