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Diabetic Custom Insert, Multiple Density, CAD/CAM Carved

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

Rates data updated July 2026.

Facilitymedian $32 · 10th–90th $32$660%50%10th90th$32Professionalmedian $32 · 10th–90th $19$480%20%10th90th$32$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
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$32.36
Typical High
$32.36
Aetna
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$31.62
Typical High
$35.48
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$54.95
Typical High
$54.95
BCBS
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$47.86
Typical High
$47.86
Cigna
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$35.48
Cigna
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$58.88
Medica
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$35.48
Typical High
$251.19
Medica
Setting
Professional
Modifier
Global
Typical Low
$16.22
Median
$26.30
Typical High
$66.07
United
Setting
Facility
Modifier
Global
Typical Low
$22.91
Median
$37.15
Typical High
$54.95
United
Setting
Professional
Modifier
Global
Typical Low
$16.22
Median
$25.70
Typical High
$38.90