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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
$114.82 / $162.18 / $537.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.05 / $524.81 / $616.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $141.25 / $281.84
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 / $177.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.49 / $158.49 / $204.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $169.82 / $223.87