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Massachusetts 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 $66 · 10th–90th $24–$1100%20%10th90th$66Professionalmedian $40 · 10th–90th $24–$520%20%10th90th$40$0.1$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$23.99 / $23.99 / $23.99
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $33.11 / $46.77
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $52.48 / $257.04
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $44.67 / $75.86
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $70.79 / $93.33
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 / $42.66
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $3,630.78 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $47.86 / $70.79
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $35.48
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $43.65
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $52.48 / $257.04
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $44.67 / $75.86
Tufts
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $47.86 / $47.86
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.04 / $27.54 / $38.02
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $39.81 / $51.29