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Diabetic Custom Insert, Multiple Density, CAD/CAM Carved

Virginia 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 $55 · 10th–90th $33$720%20%10th90th$55Professionalmedian $33 · 10th–90th $26$550%20%10th90th$33$20.0$100.0$500.0$2.0K$10.0K

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
Setting
Facility
Modifier
Global
Typical Low
$33.11
Median
$33.11
Typical High
$36.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$33.11
Typical High
$40.74
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$58.88
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$30.90
Typical High
$64.57
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$36.31
Typical High
$38.02
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
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$54.95
Typical High
$72.44
Medcost
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$38.90
Typical High
$63.10
Medcost
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$33.11
Typical High
$33.11
Sentara
Setting
Facility
Modifier
Global
Typical Low
$38.02
Median
$50.12
Typical High
$162.18
Sentara
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$50.12
Typical High
$162.18
United
Setting
Facility
Modifier
Global
Typical Low
$17.78
Median
$27.54
Typical High
$38.02
United
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$26.92
Typical High
$45.71