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Alaska rates for HCPCS A5500

For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multidensity insert(s), per shoe

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.80 / $84.57 / $84.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.47 / $59.47 / $59.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.41 / $59.47 / $61.25
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.75 / $25.75 / $25.75
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.41 / $84.41 / $133.28
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.80 / $77.80 / $86.77
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.29 / $86.77 / $178.90
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.75 / $25.75 / $73.87
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.47 / $71.56 / $109.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.32 / $84.95 / $155.13