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Utah rates for HCPCS L3253

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

Facilitymedian $16 · 10th–90th $15–$550%20%40%10th90th$16Professionalmedian $22 · 10th–90th $12–$420%10%10th90th$22$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $16.98 / $26.92
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $54.95
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $79.43
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$37.15 / $41.69 / $54.95
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $33.11 / $33.11
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $36.31 / $41.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.22 / $19.50 / $51.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $19.50 / $30.20