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Minnesota 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
$34.47 / $34.47 / $34.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.80 / $20.17 / $39.34
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.32 / $54.08 / $75.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.26 / $52.26 / $54.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.21 / $166.56 / $462.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.63 / $66.38 / $79.53
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$98.89 / $159.81 / $364.26
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.63 / $62.63 / $64.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.14 / $54.08 / $253.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.53 / $29.13 / $59.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.18 / $27.15 / $54.30