go back

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
$38.02 / $87.10 / $87.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.54 / $57.54 / $177.83
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $70.79 / $109.65
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.20 / $91.20 / $316.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $57.54 / $83.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $54.95 / $91.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $58.88 / $58.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $43.65 / $58.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.67 / $75.86 / $416.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $44.67 / $446.68
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $81.28 / $81.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.65 / $70.79 / $70.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $44.67 / $67.61