go back

Wisconsin 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.70 / $25.70 / $25.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $26.92 / $38.02
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.71 / $45.71 / $75.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $42.66 / $51.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.84 / $141.25 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.38 / $66.07 / $87.10
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.95 / $38.02 / $58.88
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $69.18 / $83.18
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.55 / $45.71 / $213.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $25.70 / $50.12
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.54 / $33.11 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $69.18 / $128.82
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.84 / $91.20 / $213.80
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.38 / $50.12 / $223.87
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $45.71 / $45.71
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $45.71 / $45.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.39 / $30.90 / $33.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $21.38 / $38.02