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

New Hampshire 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?

$57.54

Typical negotiated rate. In New Hampshire, October 2026.

Insurers have agreed to pay about $57.54 for this service. The price depends on where it is billed: about $57.54 from a physician practice, and about $91.20 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$57.54$44.67 to $63.10
FacilityA hospital or hospital-owned outpatient department$91.20$83.18 to $97.72

How much rates vary

Facilitymedian $91 · 10th to 90th $59 to $110Professionalmedian $58 · 10th to 90th $44 to $78
$50$100facility $91professional $58

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$38.90
Median
$46.77
Typical High
$85.11
Ambetter
Setting
Professional
Modifier
None
Typical Low
$63.10
Median
$63.10
Typical High
$63.10
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$83.18
Median
$97.72
Typical High
$112.20
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$5.75
Median
$5.75
Typical High
$5.75
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$43.65
Median
$43.65
Typical High
$43.65
Cigna
Setting
Facility
Modifier
None
Typical Low
$58.88
Median
$58.88
Typical High
$63.10
Cigna
Setting
Professional
Modifier
None
Typical Low
$43.65
Median
$43.65
Typical High
$58.88
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$39.81
Median
$77.62
Typical High
$125.89
United
Setting
Professional
Modifier
None
Typical Low
$30.20
Median
$44.67
Typical High
$72.44
Well Sense
Setting
Facility
Modifier
None
Typical Low
$89.13
Median
$89.13
Typical High
$89.13

Where New Hampshire 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.

New Hampshire· 32nd of 51

$57.54

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.