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Diabetic Shoe Modification, Wedge

Virginia 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?

$27.54

Typical negotiated rate. In Virginia, July 2026.

Insurers have agreed to pay about $27.54 for this service. The price depends on where it is billed: about $26.92 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$26.92$26.92 to $33.11
FacilityA hospital or hospital-owned outpatient department$45.71$31.62 to $45.71

How much rates vary

Facilitymedian $46 · 10th to 90th $27 to $56Professionalmedian $27 · 10th to 90th $21 to $45
$20$100$500$2K$10Kfacility $46professional $27

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
$26.92
Median
$26.92
Typical High
$30.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$26.92
Typical High
$33.11
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$45.71
Typical High
$48.98
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$26.92
Typical High
$56.23
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$23.99
Typical High
$31.62
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
$21.38
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$45.71
Typical High
$64.57
Medcost
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$26.30
Typical High
$26.30
Medcost
Setting
Facility
Modifier
Global
Typical Low
$17.78
Median
$31.62
Typical High
$53.70
Medcost
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$26.92
Typical High
$28.84
Sentara
Setting
Facility
Modifier
Global
Typical Low
$26.92
Median
$37.15
Typical High
$128.82
Sentara
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$37.15
Typical High
$128.82
United
Setting
Facility
Modifier
Global
Typical Low
$13.49
Median
$30.90
Typical High
$33.88
United
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$21.38
Typical High
$34.67

Where Virginia 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.

Virginia· 41st of 51

$27.54

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.