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Alabama rates for HCPCS A5504

For Diabetics Only Modification (Including Fitting) Of Off-The- Shelf Depth-Inlay Shoe Or Custom-Molded Shoe With Wedge(S) Per Shoe (Special Coverage Instructions Apply. See Mcm: 2134)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.84 / $32.84 / $32.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.16 / $32.84 / $37.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.32 / $25.32 / $25.32
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 / $52.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.79 / $20.73 / $32.52