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Georgia 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 $55 · 10th–90th $30–$2040%20%10th90th$55Professionalmedian $39 · 10th–90th $27–$710%10%20%10th90th$39$5.0$10.0$20.0$50.0$100.0$200.0$500.0

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
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $33.88 / $33.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $34.67 / $72.44
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $104.71
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $169.82 / $204.17
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $44.67 / $67.61
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $45.71
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $45.71
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 / $66.07
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $54.95 / $74.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.78 / $25.70 / $41.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $26.92 / $52.48