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Rhode Island 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
Professional
Modifier
Low / Median / High Price
$82.82 / $110.03 / $171.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$376.73 / $508.84 / $602.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.03 / $140.04 / $234.20
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 / $178.39 / $178.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.15 / $175.15 / $221.57