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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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.78 / $44.78 / $44.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.91 / $44.78 / $44.78
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.97 / $45.97 / $54.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.53 / $52.28 / $52.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.60 / $59.49 / $59.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.60 / $59.49 / $91.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.75 / $54.08 / $253.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.60 / $26.98 / $44.96
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.32 / $59.49 / $113.67
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.49 / $73.93 / $141.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.55 / $26.98 / $39.20