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New Hampshire 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

Facilitymedian $46 · 10th–90th $23–$540%20%40%10th90th$46Professionalmedian $35 · 10th–90th $21–$620%20%10th90th$35$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.91 / $22.91 / $27.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $23.99 / $61.66
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $48.98 / $56.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $28.18 / $28.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $28.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $21.38 / $28.84
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $72.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.49 / $22.39 / $33.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $28.18 / $39.81
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $30.90 / $64.57