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Colorado 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
Facility
Modifier
Low / Median / High Price
$23.25 / $23.25 / $23.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.06 / $23.25 / $38.35
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110.32 / $110.32 / $110.32
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.47 / $30.75 / $33.21
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 / $56.78
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.25 / $35.65 / $67.59
Denver HMP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.65 / $35.65 / $35.65
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.47 / $67.59 / $118.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.52 / $24.28 / $39.20