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Orthopedic Footwear, Additional Charge for Split Size

New Mexico rates for HCPCS L3257

Orthopedic footwear, additional charge for split size

Rates data updated July 2026.

Facilitymedian $19 · 10th–90th $11$330%10%10th90th$19Professionalmedian $17 · 10th–90th $8$260%20%10th90th$17$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
$12.02
Median
$12.02
Typical High
$12.02
Aetna
Setting
Professional
Modifier
Global
Typical Low
$8.13
Median
$17.38
Typical High
$21.38
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
$31.62
Molina
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$70.79
Typical High
$100.00
Providence
Setting
Facility
Modifier
Global
Typical Low
$10.72
Median
$19.95
Typical High
$35.48
Providence
Setting
Professional
Modifier
Global
Typical Low
$20.42
Median
$20.42
Typical High
$28.18
United
Setting
Facility
Modifier
Global
Typical Low
$13.18
Median
$15.49
Typical High
$17.38
United
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$14.13
Typical High
$26.30