go back

Nonstandard Size or Width

Michigan rates for HCPCS L3254

Nonstandard size or width

Rates data updated October 2026.

How much does Nonstandard Size or Width cost?

$33.11

Typical negotiated rate. In Michigan, October 2026.

Insurers have agreed to pay about $33.11 for this service. The price depends on where it is billed: about $33.11 from a physician practice, and about $83.18 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$33.11$17.78 to $44.67
FacilityA hospital or hospital-owned outpatient department$83.18$10.72 to $141

How much rates vary

Facilitymedian $83 · 10th to 90th $11 to $200Professionalmedian $33 · 10th to 90th $14 to $45
$10$20$50$100$200facility $83professional $33

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
Facility
Modifier
None
Typical Low
$17.78
Median
$17.78
Typical High
$17.78
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 Michigan
Setting
Facility
Modifier
None
Typical Low
$53.70
Median
$131.83
Typical High
$251.19
BCBS Michigan
Setting
Professional
Modifier
None
Typical Low
$42.66
Median
$44.67
Typical High
$44.67
CareSource
Setting
Facility
Modifier
None
Typical Low
$131.83
Median
$131.83
Typical High
$131.83
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
$8.71
Typical High
$10.72
Health Alliance Plan
Setting
Facility
Modifier
None
Typical Low
$14.13
Median
$89.13
Typical High
$97.72
Health Alliance Plan
Setting
Professional
Modifier
None
Typical Low
$14.13
Median
$33.11
Typical High
$43.65
Health Alliance Plan
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$7.08
Median
$7.08
Typical High
$7.08
Health Alliance Plan
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$2.82
Median
$2.82
Typical High
$2.82
Health Alliance Plan
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$2.09
Median
$2.09
Typical High
$2.09
Health Alliance Plan
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$1.41
Median
$1.41
Typical High
$1.41
Priority Health
Setting
Facility
Modifier
None
Typical Low
$10.72
Median
$10.72
Typical High
$10.72
Priority Health
Setting
Professional
Modifier
None
Typical Low
$8.71
Median
$8.71
Typical High
$10.72
United
Setting
Professional
Modifier
None
Typical Low
$51.29
Median
$51.29
Typical High
$51.29

Where Michigan 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.

Michigan· 16th of 51

$33.11

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.