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North Dakota 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
$193.87 / $193.87 / $193.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.67 / $169.93 / $193.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$249.15 / $294.58 / $301.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.00 / $312.08 / $392.43
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.69 / $193.87 / $1,247.08
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.16 / $139.59 / $212.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.80 / $132.94 / $212.31