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Washington 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 $54 · 10th–90th $36–$1100%20%10th90th$54Professionalmedian $39 · 10th–90th $17–$980%10%10th90th$39$0.5$2.0$10.0$50.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $72.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $30.20 / $97.72
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $38.90 / $54.95
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $52.48 / $52.48
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $60.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $36.31 / $36.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $36.31
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $63.10 / $112.20
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $72.44 / $117.49
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $46.77 / $60.26
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $52.48 / $53.70
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $53.70 / $58.88
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $81.28 / $107.15
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $52.48
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $52.48
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $46.77 / $60.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.99 / $41.69 / $43.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $32.36 / $46.77
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $46.77 / $83.18