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Ohio 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 $58 · 10th–90th $34–$830%20%10th90th$58Professionalmedian $33 · 10th–90th $23–$510%10%20%10th90th$33$0.5$2.0$10.0$50.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $57.54 / $57.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $33.88 / $45.71
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $40.74 / $53.70
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $57.54 / $87.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $33.11 / $72.44
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $64.57 / $75.86
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $72.44 / $87.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $38.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $36.31
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $36.31
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $36.31
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $32.36 / $46.77
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $61.66 / $114.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.42 / $40.74 / $43.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $26.92 / $41.69