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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

Facilitymedian $48 · 10th–90th $28–$830%20%10th90th$48Professionalmedian $40 · 10th–90th $24–$470%10%20%10th90th$40$1.0$5.0$20.0$100.0

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
$46.77 / $46.77 / $46.77
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $37.15 / $46.77
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.90 / $53.70
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $47.86 / $57.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $41.69 / $43.65
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 / $38.90
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $47.86 / $75.86
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.78 / $28.18 / $43.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $26.92 / $43.65
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $407.38