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Utah 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

Facilitymedian $178 · 10th–90th $78–$2690%20%40%10th90th$178Professionalmedian $174 · 10th–90th $78–$1,1480%10%10th90th$174$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $77.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $169.82 / $1,148.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $181.97
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $60.26 / $234.42
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $269.15 / $269.15
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $302.00
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $269.15 / $269.15
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $269.15 / $323.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $138.04 / $190.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $120.23 / $204.17