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Diabetic Custom Insert, Multiple Density, CAD/CAM Carved

Hawaii 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

Rates data updated July 2026.

Facilitymedian $35 · 10th–90th $19$420%50%10th90th$35Professionalmedian $55 · 10th–90th $19$580%20%10th90th$55$20.0$50.0$100.0

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

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$28.84
Typical High
$30.20
Cigna
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$35.48
Cigna
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$50.12
Typical High
$67.61
HMSA
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$57.54
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$54.95
Typical High
$77.62
United
Setting
Facility
Modifier
Global
Typical Low
$19.50
Median
$28.18
Typical High
$41.69
United
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$41.69
Typical High
$67.61