go back

Nebraska 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
$37.46 / $37.46 / $37.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.46 / $37.46 / $49.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.82 / $43.81 / $44.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.14 / $49.79 / $49.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.14 / $49.79 / $72.48
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.71 / $45.26 / $211.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.03 / $21.32 / $44.25
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.62 / $49.79 / $61.78
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.11 / $58.84 / $99.66
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.10 / $26.10 / $33.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.99 / $21.32 / $33.53