go back

Vermont 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
Professional
Modifier
Low / Median / High Price
$28.18 / $57.54 / $67.61
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $72.44 / $72.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $58.88 / $72.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $43.65 / $58.88
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $87.10 / $107.15
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.48 / $52.48 / $67.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $66.07 / $186.21