Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
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 SHAPIN
Low
$26
Average
$168
Median
$178
High
$529
Each hospital's average MultiPlan rate, under the methodology and billing class chosen below.
38 hospitals; the 90th percentile is 6.5× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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68 hospital rates
iThe hospitals that file a MultiPlan rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Bexar County Hospital District San Antonio, TX fee schedule · outpatient | 1 | $54 | $54 | — | — | — | $54 – $54 |
| 2 | Bluffton Health System LLC Bluffton, IN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $91 | $91 | — | — | — | $91 – $91 |
| 3 | Bluffton Health System LLC Bluffton, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $91 | $91 | — | — | — | $91 – $91 |
| 4 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 1 | $85 | $85 | — | — | — | $85 – $85 |
| 5 | Covenant Medical Center Inc Saginaw, MI professional · percent of total billed charges · bothfrom % of charges | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 6 | Covenant Medical Center Inc Saginaw, MI professional · percent of total billed charges · bothfrom % of charges | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 7 | Dukes Health System LLC Peru, IN facility · percent of total billed charges · inpatientfrom % of charges | 2 | $92 | $92 | — | — | — | $92 – $92 |
| 8 | Dukes Health System LLC Peru, IN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $92 | $92 | — | — | — | $92 – $92 |
| 9 | Dupont Hospital LLC Wayne, IN facility · percent of total billed charges · inpatientfrom % of charges | 2 | $100 | $100 | $2 | 2% | — | $98 – $103 |
| 10 | Dupont Hospital LLC Wayne, IN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $100 | $100 | $2 | 2% | — | $98 – $103 |
| 11 | FHN Memorial Hospital Freeport, IL percent of total billed charges · outpatientfrom % of charges | 1 | $42 | $42 | — | — | — | $42 – $42 |
| 12 | GILLETTE CHILDREN'S SPECIALTY HEALTHCARE PAUL, MN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $87 | $87 | — | — | — | $87 – $87 |
| 13 | GILLETTE CHILDREN'S SPECIALTY HEALTHCARE PAUL, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $87 | $87 | — | — | — | $87 – $87 |
| 14 | GLENCOE REGIONAL HEALTH SERVICES Glencoe, MN professional · fee schedule · outpatient | 1 | $391 | $391 | — | — | — | $391 – $391 |
| 15 | Geisinger Medical Center Muncy, PA percent of total billed charges · inpatientfrom % of charges | 2 | $260 | $260 | — | — | — | $260 – $260 |
| 16 | Geisinger Medical Center Muncy, PA percent of total billed charges · outpatientfrom % of charges | 2 | $260 | $260 | — | — | — | $260 – $260 |
| 17 | Geisinger Wyoming Valley Wilkes-Barre, PA percent of total billed charges · inpatientfrom % of charges | 2 | $162 | $162 | — | — | — | $162 – $162 |
| 18 | Geisinger Wyoming Valley Wilkes-Barre, PA percent of total billed charges · outpatientfrom % of charges | 2 | $162 | $162 | — | — | — | $162 – $162 |
| 19 | HMH HOSPITALS CORPORATION Hackensack, NJ facility · percent of total billed charges · bothfrom % of charges | 1 | $252 | $252 | — | — | — | $252 – $252 |
| 20 | HMH HOSPITALS CORPORATION Red Bank, NJ facility · percent of total billed charges · inpatientfrom % of charges | 1 | $252 | $252 | — | — | — | $252 – $252 |
| 21 | HMH HOSPITALS CORPORATION Red Bank, NJ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $252 | $252 | — | — | — | $252 – $252 |
| 22 | HMH HOSPITALS CORPORATION Edison, NJ facility · percent of total billed charges · inpatientfrom % of charges | 1 | $252 | $252 | — | — | — | $252 – $252 |
| 23 | HMH HOSPITALS CORPORATION Edison, NJ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $252 | $252 | — | — | — | $252 – $252 |
| 24 | HMH HOSPITALS CORPORATION Manahawkin, NJ facility · percent of total billed charges · inpatientfrom % of charges | 1 | $252 | $252 | — | — | — | $252 – $252 |
| 25 | HMH HOSPITALS CORPORATION Manahawkin, NJ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $252 | $252 | — | — | — | $252 – $252 |
← Payers reporting HCPCS A5513 · Snapshot 20261111T120946Z-9134e7f7