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Minnesota 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
Facility
Modifier
Low / Median / High Price
$28.85 / $28.85 / $28.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.46 / $28.85 / $31.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.75 / $45.26 / $61.24
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.21 / $43.90 / $45.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.14 / $139.66 / $387.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.50 / $55.65 / $66.68
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.92 / $134.00 / $305.44
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.50 / $52.50 / $54.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.79 / $45.26 / $211.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.79 / $21.32 / $49.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.79 / $21.43 / $58.84