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Idaho 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
Professional
Modifier
Low / Median / High Price
$25.17 / $61.33 / $61.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.79 / $29.14 / $29.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.27 / $21.27 / $31.98
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.45 / $30.18 / $61.33
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.72 / $43.00 / $45.26
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.66 / $45.26 / $79.20
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.57 / $44.25 / $66.38
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.68 / $31.68 / $47.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.39 / $29.23 / $33.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.11 / $19.19 / $33.53