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Wisconsin 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 $43$830%20%40%10th90th$46Professionalmedian $36 · 10th–90th $21$690%10%10th90th$36$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $25.70
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $26.92 / $38.02
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $75.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $42.66 / $50.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $141.25 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $66.07 / $87.10
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24.55 / $38.90 / $58.88
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $69.18 / $83.18
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24.55 / $45.71 / $213.80
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $26.30 / $50.12
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $69.18
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $52.48 / $91.20
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $69.18 / $128.82
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $91.20 / $213.80
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $42.66 / $223.87
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $45.71
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $45.71
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.39 / $30.90 / $45.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $21.38 / $40.74