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Illinois 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 $55 · 10th–90th $30–$2950%20%10th90th$55Professionalmedian $34 · 10th–90th $23–$600%10%20%10th90th$34$20.0$50.0$100.0$200.0$500.0

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
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $54.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $33.11 / $54.95
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $123.03 / $467.74
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $40.74 / $40.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $60.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $58.88
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $61.66 / $100.00
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $70.79
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $31.62 / $31.62
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $43.65 / $43.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $26.92 / $46.77