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South Dakota 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 $31 · 10th–90th $28–$560%20%40%10th90th$31Professionalmedian $35 · 10th–90th $25–$660%20%10th90th$35$20.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $28.18 / $28.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $28.84 / $61.66
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $47.86 / $50.12
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
$52.48 / $52.48 / $66.07
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $48.98 / $85.11
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $30.90 / $223.87
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $50.12 / $50.12
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $50.12
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $38.90 / $79.43
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $45.71 / $60.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $30.90 / $52.48
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $44.67