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Unclassified Diabetic Shoe Modification

Pennsylvania rates for HCPCS A5507

For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom molded shoe, per shoe

Rates data updated July 2026.

How much does Unclassified Diabetic Shoe Modification cost?

$27.54

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $27.54 for this service. The price depends on where it is billed: about $27.54 from a physician practice, and about $35.48 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 9 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$27.54$22.39 to $33.11
FacilityA hospital or hospital-owned outpatient department$35.48$22.39 to $158

How much rates vary

Facilitymedian $35 · 10th to 90th $22 to $234Professionalmedian $28 · 10th to 90th $19 to $46
$100$1K$10Kfacility $35professional $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
$22.39
Median
$22.39
Typical High
$35.48
Aetna
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$27.54
Typical High
$42.66
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$45.71
Typical High
$45.71
Cigna
Setting
Facility
Modifier
Global
Typical Low
$28.84
Median
$28.84
Typical High
$61.66
Cigna
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$21.38
Typical High
$28.84
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$60.26
Typical High
$87.10
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$45.71
Typical High
$45.71
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$32.36
Typical High
$45.71
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$22.39
Median
$22.39
Typical High
$35.48
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$19.50
Median
$27.54
Typical High
$37.15
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$42.66
Median
$154.88
Typical High
$251.19
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$42.66
Typical High
$42.66
United
Setting
Facility
Modifier
Global
Typical Low
$22.91
Median
$32.36
Typical High
$33.88
United
Setting
Professional
Modifier
Global
Typical Low
$17.38
Median
$22.91
Typical High
$46.77

Where Pennsylvania 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.

Pennsylvania· 44th 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.