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Louisiana 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
$31.02 / $38.22 / $38.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.08 / $38.22 / $42.71
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.32 / $54.08 / $54.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.03 / $0.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.85 / $33.53 / $33.53
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.12 / $47.12 / $47.12
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 / $29.14 / $43.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.18 / $25.67 / $41.58