go back

Diabetic Custom Insert, Multiple Density, CAD/CAM Carved

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

Rates data updated July 2026.

Facilitymedian $55 · 10th–90th $35$830%20%10th90th$55Professionalmedian $40 · 10th–90th $26$710%10%10th90th$40$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
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$45.71
Typical High
$57.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$34.67
Typical High
$47.86
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$40.74
Typical High
$54.95
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$57.54
Typical High
$87.10
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$48.98
Typical High
$83.18
Aultcare
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$54.95
CareSource
Setting
Facility
Modifier
Global
Typical Low
$26.92
Median
$45.71
Typical High
$64.57
CareSource
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$48.98
Typical High
$72.44
Cigna
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$38.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$35.48
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$37.15
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$33.11
Molina
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$40.74
Typical High
$57.54
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$61.66
Typical High
$114.82
United
Setting
Facility
Modifier
Global
Typical Low
$19.50
Median
$43.65
Typical High
$54.95
United
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$26.92
Typical High
$41.69