go back

Diabetic Shoe Modification, Wedge

Massachusetts 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

Rates data updated July 2026.

How much does Diabetic Shoe Modification, Wedge cost?

$39.81

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $39.81 for this service. The price depends on where it is billed: about $39.81 from a physician practice, and about $54.95 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 9 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$39.81$21.38 to $39.81
FacilityA hospital or hospital-owned outpatient department$54.95$46.77 to $66.07

How much rates vary

Facilitymedian $55 · 10th to 90th $19 to $89Professionalmedian $40 · 10th to 90th $19 to $60
$20$100$500$2Kfacility $55professional $40

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$19.05
Median
$19.05
Typical High
$19.05
Aetna
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$22.91
Typical High
$79.43
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$42.66
Median
$44.67
Typical High
$218.78
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$38.02
Typical High
$69.18
BCBS
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$57.54
Typical High
$75.86
Cigna
Setting
Facility
Modifier
Global
Typical Low
$28.84
Median
$28.84
Typical High
$28.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$21.38
Typical High
$52.48
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$3,630.78
Typical High
$9,772.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$60.26
Health New England
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$36.31
Typical High
$36.31
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$42.66
Median
$44.67
Typical High
$218.78
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$38.02
Typical High
$69.18
United
Setting
Facility
Modifier
Global
Typical Low
$15.85
Median
$30.90
Typical High
$45.71
United
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$38.90
Typical High
$42.66

Where Massachusetts sits

The same service costs 2.2 times more in Kansas than in Colorado. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Massachusetts· 7th of 51

$39.81

KS $46.77CO $21.38

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.