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Virginia 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 $55 · 10th–90th $33–$690%20%10th90th$55Professionalmedian $35 · 10th–90th $23–$550%20%10th90th$35$20.0$100.0$500.0$2.0K$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
$33.11 / $36.31 / $36.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $33.11 / $45.71
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $58.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $72.44
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $38.02
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 / $33.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $54.95 / $77.62
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $36.31 / $53.70
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.44 / $38.90 / $66.07
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $32.36 / $36.31
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $47.86 / $158.49
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $47.86 / $158.49
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.20 / $38.02 / $41.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $26.92 / $44.67