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Arizona rates for HCPCS A5503

For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom molded shoe with roller or rigid rocker bottom, per shoe

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.50 / $27.16 / $39.57
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.88 / $42.92 / $77.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.71 / $39.61 / $53.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.14 / $29.14 / $29.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.27 / $21.27 / $52.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.45 / $29.88 / $211.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.03 / $19.19 / $32.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.39 / $30.99 / $33.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.03 / $19.19 / $28.86