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Diabetic Shoe Modification, Wedge

Maine 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?

$32.36

Typical negotiated rate. In Maine, July 2026.

Insurers have agreed to pay about $32.36 for this service. The price depends on where it is billed: about $32.36 from a physician practice, and about $52.48 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 6 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$32.36$22.91 to $39.81
FacilityA hospital or hospital-owned outpatient department$52.48$30.90 to $53.70

How much rates vary

Facilitymedian $52 · 10th to 90th $29 to $60Professionalmedian $32 · 10th to 90th $19 to $40
$20$50$100facility $52professional $32

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$22.91
Typical High
$42.66
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$53.70
Typical High
$60.26
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$26.92
Typical High
$32.36
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
$28.84
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$47.86
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$11.48
Median
$22.91
Typical High
$32.36
United
Setting
Facility
Modifier
Global
Typical Low
$15.49
Median
$30.90
Typical High
$30.90
United
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$37.15
Typical High
$39.81

Where Maine 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.

Maine· 22nd of 51

$32.36

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.