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Vermont 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 (Special Coverage Instructions Apply. See Mcm: 2134)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.82 / $29.34 / $29.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.60 / $36.60 / $36.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.50 / $28.50 / $36.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.81 / $23.06 / $29.36
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.50 / $28.50 / $36.85
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.81 / $28.50 / $29.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.21 / $27.99 / $45.67