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Colorado 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.46 / $19.46 / $19.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.80 / $19.46 / $32.04
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$92.33 / $92.33 / $92.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.14 / $27.14 / $29.31
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
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.45 / $19.82 / $56.58
Denver HMP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.45 / $11.45 / $11.45
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.04 / $56.58 / $89.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.11 / $19.19 / $31.98