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Diabetic Shoe Modification, Wedge

Montana 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 Montana, July 2026.

Insurers have agreed to pay about $39.81 for this service. The price depends on where it is billed: about $38.90 from a physician practice, and about $44.67 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$38.90$20.89 to $44.67
FacilityA hospital or hospital-owned outpatient department$44.67$34.67 to $47.86

How much rates vary

Facilitymedian $45 · 10th to 90th $28 to $55Professionalmedian $39 · 10th to 90th $11 to $87
$20$50$100facility $45professional $39

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
Professional
Modifier
Global
Typical Low
$11.48
Median
$36.31
Typical High
$194.98
BCBS
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$44.67
Typical High
$44.67
Cigna
Setting
Facility
Modifier
Global
Typical Low
$28.84
Median
$47.86
Typical High
$47.86
Cigna
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$47.86
Typical High
$47.86
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$44.67
Typical High
$87.10
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$44.67
Typical High
$87.10
Providence
Setting
Facility
Modifier
Global
Typical Low
$19.95
Median
$41.69
Typical High
$52.48
Providence
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$47.86
Typical High
$79.43
United
Setting
Facility
Modifier
Global
Typical Low
$22.39
Median
$22.91
Typical High
$30.90
United
Setting
Professional
Modifier
Global
Typical Low
$15.85
Median
$19.05
Typical High
$30.90

Where Montana 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.

Montana· 8th 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.