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New Jersey 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.16 / $130.16 / $130.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.42 / $130.16 / $220.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$178.39 / $178.39 / $178.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.22 / $130.22 / $215.20
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.43 / $245.15 / $349.08
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$233.33 / $253.63 / $266.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.65 / $137.08 / $244.63