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Diabetic Custom Insert, Multiple Density, CAD/CAM Carved

Missouri 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

Rates data updated July 2026.

Facilitymedian $54 · 10th–90th $28$1320%20%40%10th90th$54Professionalmedian $31 · 10th–90th $23$630%10%20%10th90th$31$5.0$10.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$22.91
Median
$53.70
Typical High
$53.70
Aetna
Setting
Professional
Modifier
Global
Typical Low
$22.91
Median
$34.67
Typical High
$234.42
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$38.90
Typical High
$66.07
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$194.98
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$30.90
Typical High
$53.70
BCBS
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$33.11
Typical High
$54.95
Cigna
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$53.70
Cigna
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$35.48
Medica
Setting
Facility
Modifier
Global
Typical Low
$33.11
Median
$53.70
Typical High
$251.19
Medica
Setting
Professional
Modifier
Global
Typical Low
$19.50
Median
$26.92
Typical High
$83.18
United
Setting
Facility
Modifier
Global
Typical Low
$26.30
Median
$43.65
Typical High
$54.95
United
Setting
Professional
Modifier
Global
Typical Low
$19.50
Median
$26.92
Typical High
$47.86