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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 October 2026.

How much does Diabetic Depth-Inlay Shoe, Off-the-Shelf, with Fitting cost?

$87.10

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $87.10 for this service. The price depends on where it is billed: about $87.10 from a physician practice, and about $97.72 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$87.10$70.79 to $93.33
FacilityA hospital or hospital-owned outpatient department$97.72$91.20 to $5,129

How much rates vary

Facilitymedian $98 · 10th to 90th $68 to $5,248Professionalmedian $87 · 10th to 90th $40 to $100
$50$100$200$500$1K$2K$5Kfacility $98professional $87

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$27.54
Median
$41.69
Typical High
$77.62
BCBS Montana
Setting
Professional
Modifier
None
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
Cigna
Setting
Facility
Modifier
None
Typical Low
$83.18
Median
$93.33
Typical High
$93.33
Cigna
Setting
Professional
Modifier
None
Typical Low
$93.33
Median
$93.33
Typical High
$93.33
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$67.61
Median
$112.20
Typical High
$5,370.32
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$91.20
Median
$100.00
Typical High
$5,495.41
Providence
Setting
Facility
Modifier
None
Typical Low
$50.12
Median
$93.33
Typical High
$93.33
Providence
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$79.43
Typical High
$93.33
United
Setting
Professional
Modifier
None
Typical Low
$38.02
Median
$39.81
Typical High
$66.07

Where Montana sits

The same service costs 2.2 times more in Idaho than in Colorado. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Montana· 6th of 51

$87.10

ID $95.50CO $43.65

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.