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Texas rates for HCPCS A5506

For Diabetics Only Modification (Including Fitting) Of Off-The- Shelf Depth-Inlay Shoe Or Custom-Molded Shoe With Off-Set Heel(S) Per Shoe (Special Coverage Instructions Apply. See Mcm: 2134)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.55 / $29.28 / $33.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.55 / $29.68 / $39.57
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.26 / $45.26 / $45.26
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 / $29.14
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.88 / $214.99 / $214.99
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.39 / $225.39 / $339.45
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.45 / $31.68 / $45.26
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.70 / $40.72 / $45.26
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.45 / $29.68 / $45.26
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.27 / $21.27 / $35.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.99 / $24.14 / $30.48
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.94 / $27.58 / $45.26