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Indiana 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 $26–$550%20%40%10th$55Professionalmedian $34 · 10th–90th $25–$470%10%20%10th90th$34$20.0$50.0$100.0$200.0

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
$46.77 / $46.77 / $46.77
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $33.88 / $46.77
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $53.70 / $72.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $54.95 / $54.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $30.90 / $46.77
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $70.79 / $81.28
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 / $58.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.78 / $38.02 / $43.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $26.92 / $43.65