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Pennsylvania 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 $42 · 10th–90th $26–$5130%20%10th90th$42Professionalmedian $33 · 10th–90th $17–$540%20%10th90th$33$1.0$10.0$100.0$1.0K$10.0K

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
$25.70 / $41.69 / $512.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $33.11 / $51.29
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $50.12 / $53.70
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
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
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $72.44 / $104.71
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $38.90 / $54.95
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $48.98 / $131.83
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $43.65 / $43.65
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $25.70
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $33.11 / $45.71
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $18.20 / $85.11
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $38.90 / $51.29
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $51.29 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $40.74 / $41.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $28.18 / $54.95