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Idaho rates for HCPCS A5513

For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's 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

Facilitymedian $52 · 10th–90th $34–$740%20%40%10th90th$52Professionalmedian $36 · 10th–90th $16–$600%10%10th90th$36$20.0$50.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $30.20 / $72.44
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $51.29 / $87.10
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $60.26 / $60.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $36.31 / $38.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $37.15
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $52.48 / $74.13
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $52.48 / $61.66
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $38.02 / $38.90
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $52.48 / $52.48
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $38.90 / $57.54
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $54.95 / $54.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $38.02 / $41.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $24.55 / $41.69