go back

Washington, DC 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 (Special Coverage Instructions Apply. See Mcm: 2134)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.57 / $30.57 / $30.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.57 / $30.57 / $30.57
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.74 / $23.74 / $30.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.27 / $21.27 / $21.27
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.95 / $89.95 / $89.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.21 / $21.32 / $35.28