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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

Facilitymedian $35 · 10th–90th $19–$420%50%10th90th$35Professionalmedian $34 · 10th–90th $24–$580%10%10th90th$34$20.0$50.0

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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $30.20 / $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
$35.48 / $50.12 / $67.61
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $57.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $54.95 / $63.10
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $38.02 / $41.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $41.69 / $58.88