go back

Massachusetts 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
$38.02 / $38.02 / $38.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $53.70 / $177.83
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $87.10 / $426.58
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $69.18 / $128.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $114.82 / $154.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $57.54 / $57.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $58.88 / $138.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $43.65 / $69.18
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $4,897.79 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $77.62 / $117.49
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
$58.88 / $58.88 / $70.79
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $87.10 / $426.58
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $72.44 / $138.04
Tufts
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $60.26 / $79.43
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.62 / $52.48 / $63.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $61.66 / $83.18