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Idaho 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
Professional
Modifier
Low / Median / High Price
$15.97 / $46.40 / $73.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.92 / $36.21 / $36.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.43 / $26.43 / $43.67
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.68 / $37.69 / $73.39
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.67 / $51.38 / $54.08
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.97 / $54.08 / $94.64
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.35 / $52.81 / $79.22
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.86 / $37.86 / $56.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.45 / $24.28 / $41.58