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Connecticut 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
$57.54 / $57.54 / $57.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $56.23 / $97.72
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.79 / $91.20 / $109.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $60.26 / $63.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $58.88 / $58.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $43.65 / $43.65
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $57.54 / $57.54
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $66.07 / $89.13
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $58.88 / $70.79
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $70.79 / $70.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.48 / $52.48 / $58.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $44.67 / $67.61