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Maryland 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 $28 · 10th–90th $18–$390%20%10th90th$28Professionalmedian $35 · 10th–90th $26–$510%10%20%10th90th$35$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $34.67 / $51.29
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $38.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $37.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $35.48
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $54.95 / $83.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.78 / $23.44 / $38.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $27.54 / $44.67
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $38.90 / $46.77