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North Carolina 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 $48 · 10th–90th $26–$1070%10%20%10th90th$48Professionalmedian $39 · 10th–90th $19–$470%10%20%10th90th$39$20.0$50.0$100.0$200.0$500.0$1.0K$2.0K

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $46.77
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $36.31 / $46.77
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $45.71
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $41.69 / $43.65
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $36.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $38.90
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $26.92 / $36.31
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.44 / $47.86 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21.88 / $38.90 / $43.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $26.92 / $41.69
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $407.38