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Arizona rates for HCPCS A5501

For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patient's foot (custom molded shoe), per shoe

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.82 / $159.88 / $233.33
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.85 / $199.85 / $199.85
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.95 / $252.73 / $456.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.89 / $233.19 / $317.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$178.39 / $178.39 / $178.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.22 / $130.22 / $309.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.23 / $185.70 / $1,247.08
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.03 / $119.65 / $200.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.14 / $119.65 / $183.08