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Illinois rates for HCPCS A5504

For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom molded shoe with wedge(s), 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
Setting
Facility
Modifier
Global
Typical Low
$25.12
Median
$25.12
Typical High
$45.71
Aetna
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$26.92
Typical High
$45.71
BCBS
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$100.00
Typical High
$380.19
BCBS
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$33.88
Typical High
$33.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$28.84
Median
$28.84
Typical High
$50.12
Cigna
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$21.38
Typical High
$52.48
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$54.95
Typical High
$67.61
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$58.88
Typical High
$58.88
Molina
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$23.99
Typical High
$23.99
United
Setting
Facility
Modifier
Global
Typical Low
$22.39
Median
$36.31
Typical High
$36.31
United
Setting
Professional
Modifier
Global
Typical Low
$15.85
Median
$21.38
Typical High
$35.48