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Maine 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

Facilitymedian $316 · 10th–90th $178–$3630%20%40%10th90th$316Professionalmedian $186 · 10th–90th $115–$2510%10%10th90th$186$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $169.82 / $537.03
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $316.23 / $363.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $190.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $190.55
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $281.84
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $151.36 / $251.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $186.21 / $186.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $234.42 / $245.47