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Connecticut 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
Facility
Modifier
Low / Median / High Price
$28.20 / $28.20 / $28.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $28.20 / $32.04
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.08 / $45.26 / $51.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.09 / $28.09 / $29.34
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 / $29.14
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.42 / $29.42 / $29.42
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.42 / $29.42 / $41.64
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.33 / $36.33 / $36.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.10 / $29.36 / $29.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.37 / $21.32 / $39.59