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Maine 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
$19.01 / $24.52 / $24.52
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.25 / $52.15 / $96.68
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.87 / $29.34 / $29.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.50 / $28.50 / $28.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.81 / $23.32 / $28.50
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.85 / $34.85 / $34.85
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.82 / $24.52 / $24.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.09 / $21.32 / $50.10