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Hawaii 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
$26.22 / $27.60 / $28.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.56 / $70.56 / $70.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.47 / $71.75 / $97.74
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.85 / $93.04 / $93.04
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.36 / $88.85 / $124.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.04 / $70.56 / $97.74
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.55 / $71.56 / $84.57