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Tennessee 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
$45.89 / $45.89 / $57.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.80 / $51.81 / $77.72
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.85 / $88.85 / $88.85
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.93 / $79.97 / $79.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.80 / $59.47 / $59.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.41 / $43.41 / $59.47
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$149.27 / $415.82 / $422.04
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$442.47 / $442.47 / $666.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.55 / $43.39 / $63.26