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Texas 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 $51 · 10th–90th $32–$1480%10%10th90th$51Professionalmedian $31 · 10th–90th $23–$450%20%10th90th$31$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
$26.92 / $34.67 / $38.02
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $34.67 / $45.71
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $53.70 / $54.95
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $66.07 / $151.36
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $25.70
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $54.95
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 / $36.31
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $275.42 / $407.38
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $48.98 / $81.28
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $34.67 / $52.48
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $2,754.23 / $2,754.23
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $18.20 / $18.20
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $46.77 / $81.28
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $36.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.44 / $41.69 / $43.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $30.20 / $38.90
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $54.95 / $54.95