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Vermont 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 Patients 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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.19 / $40.10 / $40.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.75 / $43.75 / $43.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.60 / $35.60 / $35.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.99 / $35.59 / $53.33
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.60 / $35.60 / $35.60
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.99 / $35.60 / $53.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.98 / $37.03 / $67.01