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
$39
Average
$107
Median
$51
High
$772
Each hospital's average Regence rate, under the methodology and billing class chosen below.
15 hospitals; the 90th percentile is 2.3× 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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20 hospital rates
iThe hospitals that file a Regence 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 | ALBANY GENERAL HOSPITAL Albany, OR facility · fee schedule · both | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 2 | GOOD SAMARITAN HOSPITAL CORVALLIS Corvallis, OR facility · fee schedule · both | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 3 | GRITMAN MEDICAL CENTER INC Moscow, ID facility · fee schedule · outpatient | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 4 | GRITMAN MEDICAL CENTER INC Moscow, ID professional · fee schedule · outpatient | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 5 | MID-VALLEY HEALTHCARE INC Lebanon, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $142 | $142 | — | — | — | $142 – $142 |
| 6 | MID-VALLEY HEALTHCARE INC Lebanon, OR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 7 | Mary Bridge Children's Hospital Tacoma, WA fee schedule · outpatient | 1 | $48 | $48 | — | — | — | $48 – $48 |
| 8 | MultiCare Auburn Medical Center Auburn, WA fee schedule · outpatient | 4 | $47 | $48 | $3 | 6% | — | $46 – $53 |
| 9 | MultiCare Capital Medical Center Lacey, WA fee schedule · outpatient | 4 | $53 | $51 | $2 | 4% | — | $48 – $53 |
| 10 | MultiCare Covington Medical Center Covington, WA fee schedule · outpatient | 4 | $47 | $48 | $3 | 6% | — | $46 – $53 |
| 11 | MultiCare Valley Hospital Spokane Valley, WA fee schedule · outpatient | 1 | $53 | $53 | — | — | — | $53 – $53 |
| 12 | MultiCare Yakima Valley Memorial Hospital Association Union Gap, WA fee schedule · outpatient | 4 | $53 | $51 | $2 | 4% | — | $48 – $53 |
| 13 | SAMARITAN NORTH LINCOLN HOSPITAL Lincoln City, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $142 | $142 | — | — | — | $142 – $142 |
| 14 | SAMARITAN NORTH LINCOLN HOSPITAL Lincoln City, OR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 15 | SAMARITAN PACIFIC HEALTH SERVICES INC Newport, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $142 | $142 | — | — | — | $142 – $142 |
| 16 | SAMARITAN PACIFIC HEALTH SERVICES INC Newport, OR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $58 | $58 | — | — | — | $58 – $58 |
| 17 | Tacoma General Allenmore Hospital Bremerton, WA fee schedule · outpatient | 4 | $47 | $48 | $3 | 6% | — | $46 – $53 |
| 18 | Virginia Mason Medical Center Seattle, WA facility · percent of total billed charges · inpatientfrom % of charges | 2 | $772 | $772 | $74 | 10% | — | $699 – $846 |
| 19 | Virginia Mason Medical Center Seattle, WA facility · percent of total billed charges · outpatientfrom % of charges | 2 | $772 | $772 | $74 | 10% | — | $699 – $846 |
| 20 | WEST SHOSHONE HOSPITAL DISTRICT Kellogg, ID professional · case rate · outpatient | 1 | $39 | $39 | — | — | — | $39 – $39 |
← Payers reporting HCPCS A5513 · Snapshot 20261111T120946Z-9134e7f7