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Hawaii rates for HCPCS A5505

For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom molded shoe with metatarsal bar, per shoe

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $22.39 / $36.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.18 / $28.18 / $34.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $39.81 / $56.23
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $45.71 / $47.86
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.54 / $45.71 / $52.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.39 / $30.90 / $33.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.38 / $31.62 / $50.12