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Arizona rates for HCPCS A5514

For diabetics only, multiple density insert, made by direct carving with CAM technology from a rectified CAD model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of Shore A 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.44 / $32.45 / $47.35
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.56 / $40.56 / $40.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.20 / $51.30 / $92.74
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.45 / $47.33 / $60.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.60 / $35.60 / $35.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.99 / $25.99 / $62.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.65 / $35.70 / $253.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.56 / $24.28 / $39.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.56 / $24.28 / $39.20