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Orthopedic Footwear, Additional Charge for Split Size

New Hampshire rates for HCPCS L3257

Orthopedic footwear, additional charge for split size

Rates data updated July 2026.

Facilitymedian $17 · 10th–90th $17$200%50%10th90th$17Professionalmedian $52 · 10th–90th $15$550%50%10th90th$52$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$16.98
Median
$16.98
Typical High
$20.42
Aetna
Setting
Professional
Modifier
Global
Typical Low
$11.48
Median
$16.98
Typical High
$20.42
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$54.95
Cigna
Setting
Facility
Modifier
Global
Typical Low
$28.18
Median
$28.18
Typical High
$28.18
Cigna
Setting
Professional
Modifier
Global
Typical Low
$20.42
Median
$20.42
Typical High
$28.84
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$97.72
United
Setting
Facility
Modifier
Global
Typical Low
$8.91
Median
$14.79
Typical High
$17.78
United
Setting
Professional
Modifier
Global
Typical Low
$10.96
Median
$25.12
Typical High
$52.48