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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

Facilitymedian $46 · 10th–90th $16–$1070%10%10th90th$46Professionalmedian $34 · 10th–90th $19–$490%10%10th90th$34$0.5$2.0$10.0$50.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $33.88 / $46.77
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.13 / $58.88 / $109.65
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $53.70 / $104.71
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $35.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $35.48
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $46.77 / $109.65
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $24.55 / $269.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $43.65 / $43.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $24.55 / $38.90