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Idaho 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
$193.10 / $193.10 / $689.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.22 / $64.64 / $120.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.72 / $59.47 / $59.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.41 / $43.41 / $71.75
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.75 / $62.58 / $120.59
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.97 / $84.41 / $88.85
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.03 / $88.85 / $155.49
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.80 / $86.77 / $130.16
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.20 / $62.20 / $93.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.88 / $39.89 / $68.29