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South Carolina 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 $36 · 10th–90th $26–$620%20%10th90th$36Professionalmedian $27 · 10th–90th $19–$390%10%20%10th90th$27$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
$36.31 / $36.31 / $36.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $28.18 / $38.90
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $28.18 / $28.18
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $53.70
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $28.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $21.38 / $52.48
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $19.95
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $38.02 / $67.61
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.48 / $11.48 / $15.49
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $29.51 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.39 / $30.90 / $36.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $21.38 / $30.90