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Idaho 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
$78.67 / $233.33 / $361.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$167.13 / $178.39 / $178.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.22 / $130.22 / $215.20
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.23 / $187.70 / $361.66
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.82 / $253.15 / $266.47
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.04 / $266.47 / $466.32
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$233.33 / $260.22 / $390.33
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.53 / $186.53 / $279.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.62 / $119.65 / $204.85