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Diabetic Custom Insert, Multiple Density, CAD/CAM Carved

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

Rates data updated July 2026.

Facilitymedian $26 · 10th–90th $26$550%20%40%90th$26Professionalmedian $33 · 10th–90th $25$540%20%10th90th$33$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
Setting
Facility
Modifier
Global
Typical Low
$26.30
Median
$26.30
Typical High
$41.69
Aetna
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$33.11
Typical High
$51.29
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$46.77
Typical High
$54.95
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$53.70
Typical High
$53.70
Cigna
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$75.86
Cigna
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$35.48
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$72.44
Typical High
$104.71
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$54.95
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$36.31
Typical High
$54.95
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$40.74
Typical High
$43.65
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$26.30
Median
$26.30
Typical High
$41.69
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$21.88
Median
$33.11
Typical High
$43.65
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$51.29
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$51.29
Typical High
$51.29
United
Setting
Facility
Modifier
Global
Typical Low
$21.38
Median
$27.54
Typical High
$38.90
United
Setting
Professional
Modifier
Global
Typical Low
$20.89
Median
$26.92
Typical High
$54.95