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Tennessee 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 $39 · 10th–90th $26–$2570%20%10th90th$39Professionalmedian $34 · 10th–90th $19–$470%10%20%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
$26.92 / $31.62 / $48.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $33.88 / $46.77
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $53.70 / $54.95
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $41.69 / $44.67
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $40.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $35.48
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $407.38 / $407.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21.38 / $31.62 / $41.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $26.30 / $37.15