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New York 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
$38.65 / $43.39 / $93.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.80 / $43.39 / $84.02
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.85 / $88.85 / $177.70
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.66 / $57.66 / $149.38
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68.84 / $74.02 / $74.02
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.02 / $74.02 / $74.02
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 / $69.80
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.85 / $199.91 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.42 / $71.08 / $161.88
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.36 / $67.36 / $67.36
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.88 / $55.12 / $74.02
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.20 / $208.20 / $208.20
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.05 / $72.05 / $72.05
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.47 / $59.47 / $555.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.41 / $53.42 / $128.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.55 / $52.56 / $79.98
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.88 / $51.88 / $68.26
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.88 / $51.88 / $67.36