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Alaska rates for HCPCS A5513

For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of Shore A 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each

Facilitymedian $31 · 10th–90th $16–$550%20%40%10th90th$31Professionalmedian $39 · 10th–90th $16–$1000%10%10th90th$39$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
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $38.90 / $100.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $36.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $58.88
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $38.90 / $54.95
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $54.95 / $177.83
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $52.48 / $54.95
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $52.48 / $54.95
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $15.85 / $54.95
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $39.81 / $60.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $28.18 / $38.02
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $51.29 / $117.49