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Indiana rates for HCPCS A5501

For Diabetics Only Fitting (Including Follow-Up) Custom Preparation And Supply Of Shoe Molded From Cast(S) Of Patients Foot (Custom Molded Shoe) Per Shoe (Special Coverage Instructions Apply. See Mcm: 2134)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$228.27 / $228.27 / $266.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.00 / $169.14 / $228.27
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$210.51 / $238.49 / $266.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.63 / $171.26 / $231.20
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.85 / $293.12 / $399.71
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$226.50 / $293.12 / $359.73
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 / $178.39 / $273.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.76 / $132.94 / $200.25