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Missouri 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
$38.06 / $61.96 / $88.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.80 / $49.90 / $93.23
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.34 / $62.20 / $88.85
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.85 / $93.29 / $410.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.39 / $57.66 / $73.06
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 / $63.70
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.30 / $79.97 / $415.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.24 / $44.32 / $106.81
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.73 / $81.73 / $81.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.04 / $44.32 / $85.30