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Diabetic Depth-Inlay Shoe, Off-the-Shelf, with Fitting

Montana rates for HCPCS A5500

For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multidensity insert(s), per shoe

Rates data updated July 2026.

Facilitymedian $87 · 10th–90th $59$1100%20%10th90th$87Professionalmedian $36 · 10th–90th $28$870%20%10th90th$36$50.0$100.0$200.0

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
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$27.54
Typical High
$75.86
BCBS
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
Cigna
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$93.33
Typical High
$93.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$93.33
Typical High
$93.33
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$87.10
Typical High
$169.82
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$87.10
Typical High
$169.82
Providence
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$83.18
Typical High
$107.15
Providence
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$79.43
Typical High
$93.33
United
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$63.10
Typical High
$67.61
United
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$39.81
Typical High
$63.10