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Diabetic Custom Insert, Multiple Density, CAD/CAM Carved

North Carolina 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 $48 · 10th–90th $29$810%20%10th90th$48Professionalmedian $42 · 10th–90th $26$480%20%10th90th$42$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
$47.86
Median
$47.86
Typical High
$47.86
Aetna
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$47.86
Typical High
$47.86
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$38.90
Typical High
$38.90
BCBS
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$79.43
Typical High
$107.15
BCBS
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$41.69
Typical High
$44.67
Cigna
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$37.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$38.02
Medcost
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$47.86
Typical High
$75.86
United
Setting
Facility
Modifier
Global
Typical Low
$21.38
Median
$43.65
Typical High
$54.95
United
Setting
Professional
Modifier
Global
Typical Low
$20.42
Median
$26.92
Typical High
$43.65
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$257.04
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$407.38