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Diabetic Custom Insert, Multiple Density, CAD/CAM Carved

South Dakota 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 $58 · 10th–90th $31$740%10%20%10th90th$58Professionalmedian $51 · 10th–90th $35$780%10%20%10th90th$51$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
Facility
Modifier
Global
Typical Low
$38.90
Median
$38.90
Typical High
$38.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$37.15
Typical High
$74.13
Avera
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$57.54
Typical High
$58.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$60.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$77.62
Medica
Setting
Facility
Modifier
Global
Typical Low
$38.90
Median
$58.88
Typical High
$102.33
Medica
Setting
Professional
Modifier
Global
Typical Low
$21.88
Median
$40.74
Typical High
$269.15
Midlands
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$58.88
Typical High
$58.88
Midlands
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$60.26
Typical High
$60.26
Midlands
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$48.98
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$53.70
Typical High
$70.79
United
Setting
Facility
Modifier
Global
Typical Low
$27.54
Median
$28.18
Typical High
$40.74
United
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$41.69
Typical High
$63.10
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$53.70
Typical High
$53.70