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Maryland rates for HCPCS A5507

For Diabetics Only Not Otherwise Specified Modification (Including Fitting) Of Off-The-Shelf Depth-Inlay Shoe Or Custom- Molded Shoe Per Shoe (Special Coverage Instructions Apply. See Mcm: 2134)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.01 / $28.13 / $39.57
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.04 / $24.04 / $30.98
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 / $29.85
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.68 / $45.26 / $65.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.19 / $21.32 / $34.79
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.58 / $27.58 / $31.68