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Oklahoma 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
$158.49 / $158.49 / $158.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $158.49 / $234.42
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $234.42 / $234.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.83 / $177.83 / $177.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $128.82 / $295.12
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.90 / $177.83 / $1,258.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $138.04 / $323.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.65 / $186.21 / $269.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $120.23 / $181.97