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Arizona 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
Facility
Modifier
Low / Median / High Price
$43.60 / $52.38 / $96.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.60 / $31.76 / $71.04
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.64 / $66.64 / $88.85
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.33 / $84.27 / $152.36
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.17 / $77.75 / $97.19
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 / $43.41 / $103.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.75 / $61.91 / $415.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.01 / $39.89 / $66.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.01 / $39.89 / $62.60