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New Mexico 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 $36 · 10th–90th $26–$69,1830%20%10th90th$36Professionalmedian $35 · 10th–90th $23–$460%20%40%10th90th$35$20.0$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $38.90 / $38.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $34.67 / $45.71
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56,234.13 / $69,183.10 / $81,283.05
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $43.65 / $43.65
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $35.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $66.07
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $52.48 / $93.33
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $35.48 / $70.79
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $56.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.91 / $25.70 / $54.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $24.55 / $38.90