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Other Orthopedic Shoe Modification, Addition or Transfer

Utah rates for HCPCS L3649

Orthopedic shoe, modification, addition or transfer, not otherwise specified

Rates data updated July 2026.

Facilitymedian $16 · 10th–90th $16$160%50%$16Professionalmedian $16 · 10th–90th $6$160%20%40%10th$16$10.0$50.0$200.0$1.0K$5.0K

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
$16.22
Median
$16.22
Typical High
$16.22
Aetna
Setting
Professional
Modifier
Global
Typical Low
$6.31
Median
$10.96
Typical High
$16.22
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$44.67
Typical High
$60.26
Select Health
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$5,011.87
Typical High
$5,011.87
Select Health
Setting
Professional
Modifier
Global
Typical Low
$2,511.89
Median
$5,011.87
Typical High
$5,011.87
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$18.20
Median
$18.20
Typical High
$18.20