Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
FOR DIABETICS ONLY, FITTING (INCLUDING FOLLOW-UP), CUSTOM PREPARATION AND SUPPLY OF OFF-THE-SHELF DEPTH-INLAY SHOE MANUFACTURED TO ACCOMMODATE MULTI-DENSITY INSERT(S), PER SHOE
Low
$54
Average
$162
Median
$104
High
$424
Each hospital's average Excellus rate, under the methodology and billing class chosen below.
11 hospitals; the 90th percentile is 6.5× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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11 hospital rates
iThe hospitals that file a Excellus rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Canton-Potsdam Hospital Potsdam, NY facility · fee schedule · outpatient | 1 | $366 | $366 | — | — | — | $366 – $366 |
| 2 | Clifton Springs Hospital And Clinic Clifton Springs, NY facility · fee schedule · outpatient | 2 | $150 | $150 | $59 | 39% | — | $91 – $209 |
| 3 | F.F. Thompson Hospital Canandaigua, NY fee schedule · outpatient | 3 | $54 | $57 | $6 | 11% | — | $51 – $67 |
| 4 | Highland Hospital Rochester, NY fee schedule · outpatient | 4 | $67 | $67 | — | — | — | $67 – $67 |
| 5 | Memorial Hosp of Wm F & Gertrude F Jones A/K/A Jones Memorial Hosp Wellsville, NY fee schedule · outpatient | 1 | $54 | $54 | — | — | — | $54 – $54 |
| 6 | Newark-Wayne Community Hospital Newark, NY facility · fee schedule · outpatient | 1 | $189 | $189 | — | — | — | $189 – $189 |
| 7 | Nicholas H. Noyes Memorial Hospital Dansville, NY fee schedule · outpatient | 3 | $54 | $57 | $6 | 11% | — | $51 – $67 |
| 8 | Samaritan Medical Center Watertown, NY facility · case rate · outpatient | 2 | $253 | $253 | $163 | 64% | — | $91 – $416 |
| 9 | St. James Hospital Hornell, NY fee schedule · outpatient | 3 | $56 | $58 | $6 | 11% | — | $51 – $67 |
| 10 | Strong Memorial Hospital Rochester, NY fee schedule · outpatient | 5 | $67 | $104 | $74 | 71% | — | $67 – $253 |
| 11 | United Memorial Medical Center Batavia, NY facility · fee schedule · outpatient | 1 | $424 | $424 | — | — | — | $424 – $424 |
← Payers reporting HCPCS A5500 · Snapshot 20261111T120946Z-9134e7f7