go back

Kansas 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.71 / $59.71 / $59.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.06 / $28.82 / $59.71
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.24 / $40.56 / $40.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.03 / $45.29 / $48.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.55 / $47.55 / $47.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.60 / $35.60 / $35.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.99 / $35.59 / $78.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.82 / $54.08 / $253.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.18 / $26.98 / $74.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.64 / $26.98 / $39.20