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Connecticut 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
$34.79 / $34.79 / $34.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.80 / $32.45 / $35.51
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.91 / $54.08 / $61.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.94 / $34.94 / $36.54
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 / $36.21
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.15 / $35.15 / $35.15
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.15 / $37.86 / $54.08
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.86 / $106.86 / $130.08
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.36 / $43.36 / $43.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.12 / $26.98 / $44.96