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Montana 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 $45 · 10th–90th $28–$550%20%40%10th90th$45Professionalmedian $34 · 10th–90th $19–$620%10%10th90th$34$10.0$20.0$50.0$100.0

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
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $32.36 / $61.66
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $44.67
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $47.86 / $47.86
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $47.86 / $47.86
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $44.67 / $87.10
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $44.67 / $87.10
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $41.69 / $52.48
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $47.86 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.39 / $22.91 / $30.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $19.05 / $30.90