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Kansas 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
$59.71 / $59.71 / $59.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.68 / $28.82 / $59.71
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.86 / $40.56 / $40.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.28 / $50.62 / $53.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.09 / $48.09 / $48.09
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 / $36.21 / $78.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.68 / $46.64 / $253.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.18 / $28.91 / $69.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.18 / $26.98 / $41.58