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Washington, DC 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
$36.54 / $36.54 / $36.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.54 / $36.54 / $36.54
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.97 / $35.97 / $36.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.99 / $25.99 / $25.99
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.35 / $107.35 / $107.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.98 / $26.98 / $47.38