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Nebraska 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
$73.58 / $73.58 / $73.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.80 / $73.58 / $95.65
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.52 / $75.52 / $88.85
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.09 / $85.90 / $86.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.47 / $97.74 / $97.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.47 / $97.74 / $150.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.22 / $88.85 / $415.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.83 / $48.08 / $87.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.46 / $97.74 / $123.12
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.26 / $115.51 / $201.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.43 / $44.32 / $69.53