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Michigan 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 $132 · 10th–90th $35–$1,3180%20%10th90th$132Professionalmedian $35 · 10th–90th $26–$540%10%10th90th$35$20.0$50.0$100.0$200.0$500.0$1.0K

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
$40.74 / $1,318.26 / $1,318.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $33.88 / $46.77
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $54.95
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $162.18 / $309.03
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $53.70 / $56.23
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $35.48
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 / $28.84 / $42.66
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $75.86 / $1,318.26
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $38.90 / $66.07
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $35.48
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $43.65
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
$19.05 / $26.30 / $43.65