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Rhode Island 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 $100 · 10th–90th $32–$1260%10%20%10th90th$100Professionalmedian $31 · 10th–90th $24–$580%20%10th90th$31$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $30.90 / $57.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $107.15 / $125.89
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $30.90 / $57.54
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 / $35.48
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$29.51 / $29.51 / $32.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $34.67 / $44.67