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Vermont rates for HCPCS A5513

For Diabetics Only Multiple Density Insert Custom Molded From Model Of Patients Foot Total Contact With Patients 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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.43 / $36.54 / $36.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.75 / $43.75 / $43.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.21 / $36.21 / $36.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.43 / $36.21 / $41.80
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.21 / $36.21 / $36.21
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.43 / $36.21 / $41.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.98 / $38.51 / $62.53