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Diabetic Multiple-Density Insert, Custom Molded

Tennessee 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

Rates data updated July 2026.

Facilitymedian $45 · 10th–90th $30$2630%20%10th90th$45Professionalmedian $33 · 10th–90th $19$480%20%10th90th$33$20.0$50.0$100.0$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
Setting
Facility
Modifier
Global
Typical Low
$28.18
Median
$31.62
Typical High
$48.98
Aetna
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$33.88
Typical High
$46.77
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$41.69
Typical High
$54.95
BCBS
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$41.69
Typical High
$43.65
Cigna
Setting
Facility
Modifier
Global
Typical Low
$36.31
Median
$36.31
Typical High
$41.69
Cigna
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$26.30
Typical High
$36.31
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$263.03
Typical High
$263.03
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$407.38
Typical High
$407.38
United
Setting
Facility
Modifier
Global
Typical Low
$23.99
Median
$38.02
Typical High
$54.95
United
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$26.30
Typical High
$38.90