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Louisiana 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
$50.97 / $62.79 / $279.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.80 / $62.79 / $70.18
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.75 / $88.85 / $88.85
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.03 / $0.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.73 / $66.64 / $66.64
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.02 / $77.02 / $77.02
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 / $52.43 / $71.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.59 / $42.17 / $66.69