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South Carolina 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 $43 · 10th–90th $30–$740%20%10th90th$43Professionalmedian $34 · 10th–90th $24–$470%10%10th90th$34$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $42.66 / $42.66
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $34.67 / $46.77
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $58.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $54.95 / $67.61
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $38.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $63.10
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $47.86 / $81.28
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $35.48
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $36.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.78 / $29.51 / $43.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $26.92 / $38.90