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Oklahoma 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 $32 · 10th–90th $32–$890%50%10th90th$32Professionalmedian $33 · 10th–90th $20–$480%10%20%10th90th$33$20.0$50.0$100.0$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
$32.36 / $32.36 / $32.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $32.36 / $46.77
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $54.95
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $47.86 / $47.86
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 / $58.88
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $35.48 / $251.19
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $26.30 / $66.07
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.91 / $33.11 / $43.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $25.70 / $38.90