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West Virginia 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
$49.01 / $49.01 / $49.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.60 / $51.81 / $57.17
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.85 / $106.62 / $133.28
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.20 / $106.62 / $206.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.47 / $59.47 / $104.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.41 / $59.47 / $428.26
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.46 / $61.35 / $66.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.43 / $50.46 / $73.87