HCPCS L3201

Orthopedic shoe, oxford with supinator or pronator, infant

Current codeBelow Knee Orthotic8 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.

Prices for HCPCS L3201 by hospital
HospitalCommercial insurance rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$40.96 – $52.925 plans——
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$1051 plan——
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$38.59 – $44.105 plans——
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$38.59 – $44.105 plans——
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$63.501 plan——
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$38.59 – $44.105 plans——
Virginia Mason Medical CenterSeattle$1201 plan——
Yakima Valley MemorialYakimaFile dated 2026-08-27$45.86 – $52.925 plans——

Lowest and highest amounts each hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

CMS publishes no national amount for this code.