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Diabetic Custom Insert, Multiple Density, CAD/CAM Carved

Illinois 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 $30 · 10th–90th $30$2750%20%40%90th$30Professionalmedian $42 · 10th–90th $26$550%20%10th90th$42$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
Setting
Facility
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$54.95
Aetna
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$33.11
Typical High
$54.95
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$41.69
Typical High
$54.95
BCBS
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$316.23
Typical High
$602.56
BCBS
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$41.69
Typical High
$41.69
Cigna
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$60.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$58.88
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$74.13
Typical High
$114.82
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$30.20
United
Setting
Facility
Modifier
Global
Typical Low
$26.30
Median
$43.65
Typical High
$54.95
United
Setting
Professional
Modifier
Global
Typical Low
$20.42
Median
$26.92
Typical High
$47.86