go back

New Jersey 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
$19.30 / $19.30 / $19.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.08 / $19.30 / $37.46
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 / $31.98
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.76 / $41.64 / $59.29
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.25 / $45.26 / $45.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.03 / $26.10 / $33.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.10 / $21.32 / $36.96