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Iowa 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 Multi- Density Insert(S) Per Shoe. (Special Coverage Instructions Apply. See Mcm: 2134)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.66 / $56.66 / $64.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.61 / $56.26 / $74.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.47 / $59.47 / $97.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.47 / $98.69 / $128.91
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.61 / $88.85 / $113.22
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.71 / $114.17 / $415.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.47 / $63.26 / $121.38
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.46 / $97.74 / $121.48
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.03 / $114.17 / $186.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.47 / $44.32 / $110.14
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.07 / $87.07 / $87.07
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.79 / $87.07 / $87.07