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Connecticut 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
$34.67 / $34.67 / $34.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $33.88 / $45.71
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.66 / $54.95 / $66.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $30.90 / $37.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.48 / $35.48 / $35.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.70 / $25.70 / $25.70
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.48 / $35.48 / $35.48
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $38.90 / $60.26
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.48 / $35.48 / $35.48
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $43.65 / $43.65
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.36 / $32.36 / $36.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.42 / $26.92 / $42.66