| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.00 | $25.00 | $25.00 | |
Aetna
| Professional | $25.00 | $25.00 | $25.00 | |
CareFirst
| Professional | $36.27 | $36.27 | $36.27 | |
Cigna
| Professional | $23.90 | $23.90 | $23.90 |
For diabetics only, direct formed, compression molded to patient's foot without external heat source, multiple-density insert(s) prefabricated, per shoe
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.00 | $25.00 | $25.00 | |
Aetna
| Professional | $25.00 | $25.00 | $25.00 | |
CareFirst
| Professional | $36.27 | $36.27 | $36.27 | |
Cigna
| Professional | $23.90 | $23.90 | $23.90 |