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Washington, DC 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
$36.54 / $36.54 / $36.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.80 / $36.54 / $36.54
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.19 / $30.19 / $36.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.43 / $26.43 / $26.43
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.35 / $107.35 / $107.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.98 / $26.98 / $44.65