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Georgia 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
$34.24 / $34.24 / $34.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.48 / $34.79 / $49.55
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.48 / $38.65 / $40.02
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.08 / $75.70 / $198.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.69 / $44.96 / $102.87
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.97 / $75.70 / $94.64
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.97 / $54.08 / $75.70
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.08 / $54.08 / $71.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.98 / $26.98 / $46.79