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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 Patients 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