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Minnesota 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
$169.93 / $169.93 / $169.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.67 / $169.93 / $193.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$228.27 / $266.47 / $371.06
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.18 / $258.48 / $266.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$178.39 / $822.47 / $2,284.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.00 / $327.54 / $392.43
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$488.29 / $789.12 / $1,798.69
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.00 / $309.00 / $318.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.56 / $266.47 / $1,247.08
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.76 / $132.94 / $293.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.76 / $120.03 / $267.58