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Ohio 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 $58 · 10th–90th $34–$830%20%10th90th$58Professionalmedian $35 · 10th–90th $24–$650%10%20%10th90th$35$0.5$2.0$10.0$50.0$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
$33.88 / $45.71 / $57.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $33.88 / $45.71
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $53.70 / $54.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $57.54 / $87.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $48.98 / $83.18
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $45.71 / $64.57
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $48.98 / $72.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $37.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $35.48
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $35.48
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $33.11
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $40.74 / $58.88
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $61.66 / $114.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $38.02 / $43.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $26.30 / $41.69