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New Mexico 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 $39 · 10th–90th $16–$740%10%20%10th90th$39Professionalmedian $35 · 10th–90th $17–$460%20%40%10th90th$35$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$38.90 / $38.90 / $38.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $34.67 / $45.71
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56,234.13 / $69,183.10 / $81,283.05
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $43.65 / $51.29
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 / $66.07
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $79.43 / $117.49
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $38.90 / $64.57
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $56.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.99 / $41.69 / $54.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $24.55 / $36.31