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Diabetic Shoe Modification, Metatarsal Bar

Illinois rates for HCPCS A5505

For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom molded shoe with metatarsal bar, per shoe

Rates data updated July 2026.

How much does Diabetic Shoe Modification, Metatarsal Bar cost?

$28.84

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $28.84 for this service. The price depends on where it is billed: about $28.18 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 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$28.18$25.70 to $45.71
FacilityA hospital or hospital-owned outpatient department$45.71$25.70 to $81.28

How much rates vary

Facilitymedian $46 · 10th to 90th $26 to $234Professionalmedian $28 · 10th to 90th $21 to $51
$20$50$100$200$500facility $46professional $28

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
$25.70
Median
$25.70
Typical High
$45.71
Aetna
Setting
Professional
Modifier
Global
Typical Low
$20.89
Median
$28.18
Typical High
$45.71
BCBS
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$100.00
Typical High
$380.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$28.18
Median
$28.18
Typical High
$50.12
Cigna
Setting
Professional
Modifier
Global
Typical Low
$20.89
Median
$20.89
Typical High
$50.12
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$54.95
Typical High
$67.61
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$58.88
Typical High
$58.88
Molina
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$23.99
Typical High
$37.15
United
Setting
Facility
Modifier
Global
Typical Low
$26.30
Median
$36.31
Typical High
$45.71
United
Setting
Professional
Modifier
Global
Typical Low
$15.85
Median
$21.38
Typical High
$38.90

Where Illinois sits

The same service costs 2.3 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.

Illinois· 31st of 51

$28.84

KS $48.98CO $20.89

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.