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New York 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
$24.51 / $28.96 / $51.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.13 / $28.96 / $51.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.08 / $54.08 / $108.16
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.75 / $30.75 / $93.07
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.90 / $45.05 / $45.05
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.05 / $45.05 / $45.05
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 / $42.48
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.22 / $78.34 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.53 / $41.02 / $98.97
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.02 / $41.02 / $41.02
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.36 / $38.64 / $45.05
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.68 / $45.68 / $45.68
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.60 / $35.60 / $555.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.99 / $33.42 / $80.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.98 / $30.88 / $49.46
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.36 / $36.36 / $36.36
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.36 / $36.36 / $41.02