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Maine 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 $63 · 10th–90th $35–$720%20%40%10th90th$63Professionalmedian $35 · 10th–90th $24–$510%10%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
$22.91 / $34.67 / $51.29
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $64.57 / $72.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $30.90 / $38.90
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 / $38.02
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $47.86 / $56.23
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $30.90 / $51.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $38.02 / $38.02
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $47.86 / $50.12