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Diabetic Custom Insert, Multiple Density, CAD/CAM Carved

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

Rates data updated July 2026.

Facilitymedian $100 · 10th–90th $32$1260%10%20%10th90th$100Professionalmedian $27 · 10th–90th $25$410%20%10th90th$27$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
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$24.55
Typical High
$40.74
BCBS
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$107.15
Typical High
$125.89
BCBS
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$30.90
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
$25.70
United
Setting
Facility
Modifier
Global
Typical Low
$29.51
Median
$29.51
Typical High
$32.36
United
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$34.67
Typical High
$44.67