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Maryland 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
$52.42 / $229.16 / $314.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.60 / $54.46 / $77.80
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.59 / $49.59 / $60.74
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 / $43.41 / $61.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.20 / $88.85 / $127.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.58 / $44.32 / $70.28
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.42 / $56.42 / $62.20