go back

Rhode Island 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
Professional
Modifier
Low / Median / High Price
$13.50 / $17.93 / $28.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.74 / $86.53 / $101.42
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.82 / $22.82 / $39.83
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 / $21.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.19 / $27.93 / $35.53