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Oklahoma 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
$32.20 / $32.20 / $37.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.80 / $32.20 / $35.50
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.08 / $54.08 / $54.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.35 / $47.35 / $47.35
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 / $36.21 / $43.67
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.68 / $33.81 / $253.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.18 / $28.87 / $54.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.18 / $24.39 / $38.04