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Missouri 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 $263 · 10th–90th $129–$6460%20%10th90th$263Professionalmedian $170 · 10th–90th $115–$2630%20%10th90th$170$20.0$50.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $263.03 / $263.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $169.82 / $281.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $954.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $169.82 / $251.19
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $269.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $177.83
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $223.87 / $1,258.93
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $131.83 / $1,318.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $218.78 / $218.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $131.83 / $204.17