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{"negotiation_arrangement":"ffs","name":"Heel, counter, plastic reinforced","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","description":"Heel, counter, plastic reinforced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"fee schedule","negotiated_rate":131.92,"expiration_date":"9999-12-31","service_code":["11"],"billing_class":"professional"}],"provider_references":[1109278684]}]},
{"negotiation_arrangement":"ffs","name":"Heel, pad, removable for spur","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3485","description":"Heel, pad, removable for spur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":70.0,"expiration_date":"9999-12-31","service_code":["11"],"billing_class":"professional"}],"provider_references":[1109278684]}]},
{"negotiation_arrangement":"ffs","name":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"fee schedule","negotiated_rate":89.5,"expiration_date":"9999-12-31","service_code":["11"],"billing_class":"professional"}],"provider_references":[1109278684]}]},
{"negotiation_arrangement":"ffs","name":"Sole wedge, between sole","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","description":"Sole wedge, between sole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"fee schedule","negotiated_rate":40.8,"expiration_date":"9999-12-31","service_code":["11"],"billing_class":"professional"}],"provider_references":[1109278684]}]},
{"negotiation_arrangement":"ffs","name":"Orthopedic shoe addition, convert firm shoe counter to soft counter","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"fee schedule","negotiated_rate":43.97,"expiration_date":"9999-12-31","service_code":["11"],"billing_class":"professional"}],"provider_references":[1109278684]}]},
{"negotiation_arrangement":"ffs","name":"WRIST HAND ORTHOSIS 1/>NONTORSION JNT PRFAB CSTM","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","description":"WRIST HAND ORTHOSIS 1/>NONTORSION JNT PRFAB CSTM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"fee schedule","negotiated_rate":398.23,"expiration_date":"9999-12-31","service_code":["11"],"billing_class":"professional"}],"provider_references":[1109278684]}]},
{"negotiation_arrangement":"ffs","name":"Orthopedic shoe addition, March bar","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","description":"Orthopedic shoe addition, March bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"fee schedule","negotiated_rate":34.54,"expiration_date":"9999-12-31","service_code":["11"],"billing_class":"professional"}],"provider_references":[1109278684]}]},
{"negotiation_arrangement":"ffs","name":"Transfer of an orthosis from one shoe to another, caliper plate, existing","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"fee schedule","negotiated_rate":62.83,"expiration_date":"9999-12-31","service_code":["11"],"billing_class":"professional"}],"provider_references":[1109278684]}]},
{"negotiation_arrangement":"ffs","name":"SHOULDER ORTHOTIC ABDUCT PSTN THOR COMP CUSTOM","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","description":"SHOULDER ORTHOTIC ABDUCT PSTN THOR COMP CUSTOM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"fee schedule","negotiated_rate":885.55,"expiration_date":"9999-12-31","service_code":["11"],"billing_class":"professional"}],"provider_references":[1109278684]}]},
{"negotiation_arrangement":"ffs","name":"Foot insert, removable, molded to patient model, UCB type, Berkeley shell, each","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","description":"Foot insert, removable, molded to patient model, UCB type, Berkeley shell, each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"fee schedule","negotiated_rate":258.59,"expiration_date":"9999-12-31","service_code":["11"],"billing_class":"professional"}],"provider_references":[1109278684]}]},
{"negotiation_arrangement":"ffs","name":"Shoulder-elbow-wrist-hand orthotic (SEWHO), abduction positioning, Erb's palsy design, prefabricated, includes fitting and adjustment","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","description":"Shoulder-elbow-wrist-hand orthotic (SEWHO), abduction positioning, Erb's palsy design, prefabricated, includes fitting and adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"fee schedule","negotiated_rate":738.25,"expiration_date":"9999-12-31","service_code":["11"],"billing_class":"professional"}],"provider_references":[1109278684]}]},
{"negotiation_arrangement":"ffs","name":"UPPER EXTREMITY FX ORTHOSIS HUMERAL PREF STRAPS","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","description":"UPPER EXTREMITY FX ORTHOSIS HUMERAL PREF STRAPS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"fee schedule","negotiated_rate":754.1,"expiration_date":"9999-12-31","service_code":["11"],"billing_class":"professional"}],"provider_references":[1109278684]}]},
{"negotiation_arrangement":"ffs","name":"Upper extremity fracture orthotic, humeral, prefabricated, includes fitting and adjustment","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","description":"Upper extremity fracture orthotic, humeral, prefabricated, includes fitting and adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"fee schedule","negotiated_rate":318.09,"expiration_date":"9999-12-31","service_code":["11"],"billing_class":"professional"}],"provider_references":[1109278684]}]},
{"negotiation_arrangement":"ffs","name":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"fee schedule","negotiated_rate":80.56,"expiration_date":"9999-12-31","service_code":["11"],"billing_class":"professional"}],"provider_references":[1109278684]}]},
{"negotiation_arrangement":"ffs","name":"Sole wedge, outside sole","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","description":"Sole wedge, outside sole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"fee schedule","negotiated_rate":29.32,"expiration_date":"9999-12-31","service_code":["11"],"billing_class":"professional"}],"provider_references":[1109278684]}]},
{"negotiation_arrangement":"ffs","name":"Orthopedic shoe, hightop with supinator or pronator, child","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3206","description":"Orthopedic shoe, hightop with supinator or pronator, child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":70.0,"expiration_date":"9999-12-31","service_code":["11"],"billing_class":"professional"}],"provider_references":[1109278684]}]},
{"negotiation_arrangement":"ffs","name":"SEWHFO ABDUCT PSTN THOR CMPNT&SUPP BAR CSTM FAB","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","description":"SEWHFO ABDUCT PSTN THOR CMPNT&SUPP BAR CSTM FAB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"fee schedule","negotiated_rate":1486.1,"expiration_date":"9999-12-31","service_code":["11"],"billing_class":"professional"}],"provider_references":[1109278684]}]},
{"negotiation_arrangement":"ffs","name":"Lift, elevation, metal extension (skate)","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","description":"Lift, elevation, metal extension (skate)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"fee schedule","negotiated_rate":465.89,"expiration_date":"9999-12-31","service_code":["11"],"billing_class":"professional"}],"provider_references":[1109278684]}]},
{"negotiation_arrangement":"ffs","name":"FINGER ORTHOSIS PIP/DIP NONTORSION JOINT PREFAB","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","description":"FINGER ORTHOSIS PIP/DIP NONTORSION JOINT PREFAB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"fee schedule","negotiated_rate":40.27,"expiration_date":"9999-12-31","service_code":["11"],"billing_class":"professional"}],"provider_references":[1109278684]}]}]}
