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Nebraska 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 $54 · 10th–90th $26–$2510%10%10th90th$54Professionalmedian $44 · 10th–90th $22–$1170%10%10th90th$44$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $43.65 / $43.65
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $43.65 / $234.42
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $45.71
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $52.48 / $52.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $60.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $63.10 / $93.33
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $74.13 / $251.19
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $26.92 / $44.67
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $144.54
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $134.90 / $144.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.78 / $29.51 / $43.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $26.92 / $43.65