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Washington 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 $269 · 10th–90th $178–$5370%20%10th90th$269Professionalmedian $195 · 10th–90th $112–$3890%5%10%10th90th$195$2.0$10.0$50.0$200.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $354.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $151.36 / $263.03
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $263.03 / $263.03
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $302.00
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 / $177.83
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $309.03 / $549.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $354.81 / $588.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $229.09 / $281.84
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $263.03 / $269.15
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $269.15 / $269.15
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $407.38 / $537.03
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $263.03
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $263.03
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $229.09 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $204.17 / $218.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $158.49 / $229.09
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $229.09 / $407.38