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Vermont 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
$140.04 / $180.05 / $180.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$215.59 / $215.59 / $215.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$178.39 / $178.39 / $217.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.22 / $153.75 / $183.74
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$178.39 / $178.39 / $217.80
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.22 / $178.39 / $183.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.17 / $157.85 / $308.05