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New York 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
$19.00 / $19.30 / $42.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $22.16 / $42.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.26 / $45.26 / $90.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.09 / $28.09 / $72.78
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.42 / $37.01 / $37.01
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.01 / $37.01 / $37.01
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 / $33.58
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.26 / $101.84 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.34 / $33.95 / $82.83
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.93 / $32.93 / $32.93
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.07 / $24.52 / $37.01
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.14 / $29.14 / $555.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.27 / $27.18 / $65.63
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.59 / $26.10 / $30.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.21 / $26.48 / $42.75
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.07 / $23.07 / $30.36
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.07 / $23.07 / $32.93