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Pennsylvania 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 $42 · 10th–90th $26–$1580%20%10th90th$42Professionalmedian $33 · 10th–90th $23–$540%20%10th90th$33$1.0$10.0$100.0$1.0K$10.0K

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
$25.70 / $41.69 / $158.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $33.11 / $51.29
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
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
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $72.44 / $104.71
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $36.31 / $54.95
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $41.69 / $43.65
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $25.70
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $33.11 / $46.77
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $107.15 / $107.15
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $48.98 / $51.29
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $50.12 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21.38 / $27.54 / $38.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $26.92 / $54.95