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Arizona rates for HCPCS A5513

For Diabetics Only Multiple Density Insert Custom Molded From Model Of Patients Foot Total Contact With Patients 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.02 / $58.02 / $58.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.80 / $23.25 / $47.35
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.56 / $40.56 / $54.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.20 / $51.30 / $92.74
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.50 / $47.33 / $62.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.21 / $36.21 / $36.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.43 / $26.43 / $62.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.68 / $36.14 / $253.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.93 / $24.28 / $40.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.95 / $24.28 / $37.15