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Diabetic Shoe Modification, Metatarsal Bar

Ohio 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?

$28.18

Typical negotiated rate. In Ohio, July 2026.

Insurers have agreed to pay about $28.18 for this service. The price depends on where it is billed: about $25.70 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$25.70$19.50 to $30.90
FacilityA hospital or hospital-owned outpatient department$45.71$37.15 to $48.98

How much rates vary

Facilitymedian $46 · 10th to 90th $29 to $69Professionalmedian $26 · 10th to 90th $17 to $45
$20$50$100facility $46professional $26

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
$28.84
Median
$37.15
Typical High
$47.86
Aetna
Setting
Professional
Modifier
Global
Typical Low
$19.50
Median
$28.84
Typical High
$38.90
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$47.86
Typical High
$72.44
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$16.98
Median
$22.91
Typical High
$57.54
CareSource
Setting
Facility
Modifier
Global
Typical Low
$22.39
Median
$38.90
Typical High
$53.70
CareSource
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$40.74
Typical High
$61.66
Cigna
Setting
Facility
Modifier
Global
Typical Low
$28.18
Median
$28.18
Typical High
$31.62
Cigna
Setting
Professional
Modifier
Global
Typical Low
$20.89
Median
$20.89
Typical High
$28.18
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$28.18
Median
$28.18
Typical High
$30.20
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$20.89
Median
$20.89
Typical High
$20.89
Molina
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$34.67
Typical High
$47.86
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$50.12
Typical High
$93.33
United
Setting
Facility
Modifier
Global
Typical Low
$15.85
Median
$36.31
Typical High
$45.71
United
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$21.38
Typical High
$33.88

Where Ohio 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.

Ohio· 39th of 51

$28.18

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.