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North Dakota 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.34 / $39.34 / $39.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.44 / $34.47 / $39.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.57 / $59.79 / $61.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.63 / $63.25 / $79.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.47 / $43.26 / $253.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.78 / $28.32 / $52.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.18 / $27.44 / $43.56