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New York 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.05 / $35.48 / $51.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $28.18 / $42.66
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.71 / $45.71 / $91.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.54 / $27.54 / $52.48
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $37.15 / $37.15
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.15 / $37.15 / $37.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.84 / $72.44 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.38 / $21.38 / $45.71
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.71 / $75.86 / $177.83
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $50.12 / $89.13
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.11 / $33.11 / $34.67
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.91 / $24.55 / $33.11
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.79 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $44.67 / $44.67
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.78 / $26.30 / $30.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.13 / $21.88 / $38.90
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.91 / $30.20 / $34.67
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.91 / $24.55 / $33.11