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Illinois rates for HCPCS A5503

For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom molded shoe with roller or rigid rocker bottom, per shoe

Facilitymedian $46 · 10th–90th $25–$2450%20%10th90th$46Professionalmedian $30 · 10th–90th $19–$460%10%10th90th$30$10.0$20.0$50.0$100.0$200.0$500.0

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $25.12 / $45.71
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $26.92 / $45.71
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $100.00 / $380.19
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $33.88 / $33.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $50.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $21.38 / $52.48
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $53.70 / $67.61
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $58.88
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $23.99 / $23.99
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.39 / $36.31 / $36.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $21.38 / $35.48