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Montana 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 $174–$3240%20%10th90th$263Professionalmedian $204 · 10th–90th $115–$3630%10%10th90th$204$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
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $194.98 / $363.08
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $263.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $281.84 / $281.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $281.84 / $281.84
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $263.03 / $512.86
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $263.03 / $512.86
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $213.80 / $323.59
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $208.93 / $281.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $186.21 / $204.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $120.23 / $190.55