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Oregon 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 $52 · 10th–90th $42–$540%50%10th90th$52Professionalmedian $32 · 10th–90th $17–$600%10%10th90th$32$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
$38.90 / $38.90 / $38.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $26.92 / $46.77
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 / $26.30
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $107.15 / $123.03
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $43.65 / $56.23
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $43.65 / $60.26
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $52.48 / $53.70
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $53.70 / $58.88
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $48.98 / $72.44
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $51.29 / $79.43
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $85.11 / $213.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $60.26 / $60.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $41.69 / $41.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $24.55 / $46.77