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Wyoming 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
$114.58 / $114.58 / $233.33
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$260.22 / $260.22 / $260.22
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.22 / $260.22 / $260.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$178.39 / $178.39 / $293.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.22 / $130.22 / $178.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.14 / $129.62 / $204.85