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West Virginia 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
Facility
Modifier
Low / Median / High Price
$147.00 / $147.00 / $147.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.00 / $163.33 / $180.08
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.21 / $359.73 / $466.32
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.21 / $186.53 / $319.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$178.39 / $178.39 / $312.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.22 / $178.39 / $1,284.39
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$319.86 / $319.86 / $319.86
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.93 / $179.93 / $179.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.28 / $142.43 / $231.45