go back

Washington 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 $28–$910%20%10th90th$46Professionalmedian $31 · 10th–90th $19–$650%10%10th90th$31$0.5$2.0$10.0$50.0

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 / $60.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $25.70 / $61.66
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $44.67 / $44.67
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $38.90 / $50.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $28.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $21.38 / $28.84
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $52.48 / $93.33
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $58.88 / $100.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $43.65 / $64.57
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $44.67 / $45.71
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $45.71 / $45.71
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $69.18 / $91.20
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $44.67
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $44.67
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $38.90 / $50.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.78 / $33.88 / $36.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $23.99 / $38.90
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $38.90 / $69.18