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Minnesota 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 $47–$3980%20%10th90th$63Professionalmedian $54 · 10th–90th $30–$630%20%40%10th90th$54$0.5$2.0$10.0$50.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $33.88 / $33.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $33.88 / $45.71
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $53.70 / $70.79
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $53.70 / $53.70
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $204.17 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $69.18 / $79.43
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $199.53 / $398.11
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $85.11
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $53.70 / $251.19
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $26.92 / $100.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $32.36 / $38.02
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $28.18 / $75.86