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Maine 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 $63 · 10th–90th $36–$720%20%40%10th90th$63Professionalmedian $35 · 10th–90th $21–$620%10%10th90th$35$20.0$50.0$100.0$200.0

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $33.88 / $100.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $64.57 / $72.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $38.90
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $38.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $38.90
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $47.86 / $56.23
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $30.90 / $51.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $38.02 / $38.02
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $47.86 / $50.12