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New Jersey 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
$28.96 / $28.96 / $28.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.82 / $28.96 / $44.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.60 / $35.60 / $35.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.99 / $25.99 / $43.67
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.75 / $59.49 / $70.84
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.81 / $54.08 / $54.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.63 / $26.98 / $44.96