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Wisconsin rates for HCPCS A5512

For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees Fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of Shore A 35 durometer or 3/16 inch material of Shore A 40 durometer (or higher), prefabricated, each

Facilitymedian $37 · 10th–90th $35–$680%20%40%10th90th$37Professionalmedian $28 · 10th–90th $17–$550%10%10th90th$28$10.0$20.0$50.0$100.0$200.0

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.89 / $20.89 / $20.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $20.89 / $30.90
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$37.15 / $37.15 / $61.66
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $41.69
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.99 / $114.82 / $181.97
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $52.48 / $69.18
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.20 / $31.62 / $52.48
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $51.29 / $61.66
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.42 / $36.31 / $169.82
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.60 / $23.44 / $42.66
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $58.88
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $41.69 / $72.44
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $54.95 / $102.33
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.99 / $74.13 / $173.78
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $35.48 / $181.97
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $37.15 / $37.15
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $37.15 / $37.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $25.70 / $37.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.49 / $18.20 / $33.88