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Nonstandard Size or Width

Arizona rates for HCPCS L3254

Nonstandard size or width

Rates data updated October 2026.

How much does Nonstandard Size or Width cost?

$17.78

Typical negotiated rate. In Arizona, October 2026.

Insurers have agreed to pay about $17.78 for this service. The price depends on where it is billed: about $17.78 from a physician practice, and about $25.70 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$17.78$10.72 to $23.44
FacilityA hospital or hospital-owned outpatient department$25.70$13.49 to $41.69

How much rates vary

Facilitymedian $26 · 10th to 90th $8 to $56Professionalmedian $18 · 10th to 90th $8 to $29
$10$20$50$100facility $26professional $18

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$17.78
Median
$17.78
Typical High
$17.78
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$8.91
Median
$8.91
Typical High
$8.91
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$3.55
Median
$3.55
Typical High
$3.55
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$2.69
Median
$2.69
Typical High
$2.69
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$1.78
Median
$1.78
Typical High
$1.78
BCBS Arizona
Setting
Facility
Modifier
None
Typical Low
$6.92
Median
$31.62
Typical High
$47.86
BCBS Arizona
Setting
Professional
Modifier
None
Typical Low
$20.42
Median
$23.44
Typical High
$41.69
Cigna
Setting
Facility
Modifier
None
Typical Low
$10.72
Median
$10.72
Typical High
$10.72
Cigna
Setting
Professional
Modifier
None
Typical Low
$7.76
Median
$7.76
Typical High
$10.72
Medica
Setting
Facility
Modifier
None
Typical Low
$14.45
Median
$19.50
Typical High
$100.00
Medica
Setting
Professional
Modifier
None
Typical Low
$15.14
Median
$15.14
Typical High
$47.86
United
Setting
Professional
Modifier
None
Typical Low
$30.90
Median
$30.90
Typical High
$52.48

Where Arizona sits

The same service costs 27.5 times more in Kansas than in South Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Arizona· 22nd of 51

$17.78

KS $138SC $5.01

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.