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Nonstandard Size or Width

Pennsylvania rates for HCPCS L3254

Nonstandard size or width

Rates data updated October 2026.

How much does Nonstandard Size or Width cost?

$14.13

Typical negotiated rate. In Pennsylvania, October 2026.

Insurers have agreed to pay about $14.13 for this service. The price depends on where it is billed: about $14.13 from a physician practice, and about $10.72 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$14.13$7.76 to $14.13
FacilityA hospital or hospital-owned outpatient department$10.72$10.72 to $10.72

How much rates vary

Facilitymedian $11 · 10th to 90th $11 to $14Professionalmedian $14 · 10th to 90th $8 to $14
$10facility $11professional $14

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
$14.13
Median
$14.13
Typical High
$14.13
Aetna
Setting
Professional
Modifier
None
Typical Low
$14.13
Median
$14.13
Typical High
$14.13
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$7.08
Median
$7.08
Typical High
$7.08
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$2.82
Median
$2.82
Typical High
$2.82
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$2.09
Median
$2.09
Typical High
$2.09
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$1.41
Median
$1.41
Typical High
$1.41
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
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$14.13
Median
$14.13
Typical High
$14.13
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$14.13
Median
$14.13
Typical High
$14.13
Martin's Point
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$7.08
Median
$7.08
Typical High
$7.08
Martin's Point
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$2.82
Median
$2.82
Typical High
$2.82
Martin's Point
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$2.09
Median
$2.09
Typical High
$2.09
Martin's Point
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$1.41
Median
$1.41
Typical High
$1.41
Oscar Health
Setting
Professional
Modifier
None
Typical Low
$23.44
Median
$23.44
Typical High
$23.44
United
Setting
Professional
Modifier
None
Typical Low
$51.29
Median
$51.29
Typical High
$51.29

Where Pennsylvania 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.

Pennsylvania· 34th of 51

$14.13

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.