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Diabetic Shoe Modification, Wedge

South Dakota 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?

$44.67

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $44.67 for this service. The price depends on where it is billed: about $42.66 from a physician practice, and about $45.71 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 8 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$42.66$30.90 to $52.48
FacilityA hospital or hospital-owned outpatient department$45.71$30.90 to $52.48

How much rates vary

Facilitymedian $46 · 10th to 90th $29 to $62Professionalmedian $43 · 10th to 90th $29 to $66
$20$50$100$200facility $46professional $43

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
Facility
Modifier
Global
Typical Low
$30.90
Median
$30.90
Typical High
$30.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$30.90
Typical High
$61.66
Avera
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$47.86
Typical High
$50.12
Cigna
Setting
Facility
Modifier
Global
Typical Low
$28.84
Median
$28.84
Typical High
$50.12
Cigna
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$66.07
Medica
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$48.98
Typical High
$85.11
Medica
Setting
Professional
Modifier
Global
Typical Low
$17.38
Median
$30.90
Typical High
$223.87
Midlands
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$50.12
Typical High
$50.12
Midlands
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$50.12
Typical High
$50.12
Midlands
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$38.90
Typical High
$79.43
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$45.71
Typical High
$60.26
United
Setting
Facility
Modifier
Global
Typical Low
$22.39
Median
$30.90
Typical High
$31.62
United
Setting
Professional
Modifier
Global
Typical Low
$15.85
Median
$30.90
Typical High
$52.48
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$44.67
Typical High
$44.67

Where South Dakota 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.

South Dakota· 5th of 51

$44.67

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.