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South Carolina 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
$36.17 / $36.17 / $36.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.95 / $36.17 / $39.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $36.92 / $52.75
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 / $27.64 / $33.58
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.28 / $36.17 / $71.05
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.72 / $27.72 / $27.72
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.71 / $29.71 / $3,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.21 / $20.66 / $31.10