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
Current codeBelow Knee Orthotic12 hospitals with prices
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $47.53 – $322 | — | — |
| Deaconess Medical Center | $66.01 – $82.35 | — | — |
| Harborview Medical Center | — | $67.57 | $96.53 |
| Mary Bridge Children's Hospital | $47.53 – $116 | — | — |
| MultiCare Auburn Medical Center | $46.21 – $116 | — | — |
| MultiCare Covington Medical Center | $46.21 – $116 | — | — |
| MultiCare Good Samaritan Hospital | $62.73 – $116 | — | — |
| MultiCare Valley Hospital | $52.81 – $82.35 | — | — |
| Overlake Hospital Medical Center & Clinics | $108 – $136 | — | — |
| Tacoma General Allenmore Hospital | $46.21 – $116 | — | — |
| Virginia Mason Medical Center | $169 – $192 | — | — |
| Yakima Valley Memorial | $47.53 – $81.86 | — | — |
Medicare (traditional) reference
Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.
- Equipment fee, Washington
- $55.16 (fee)