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Mississippi 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.98 / $44.98 / $46.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.39 / $43.56 / $46.40
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.86 / $47.32 / $47.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.91 / $41.91 / $41.91
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.91 / $41.91 / $41.91
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 / $26.43 / $36.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.18 / $26.98 / $67.44