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Ohio rates for HCPCS L5200

Above knee (AK), molded socket, single axis constant friction knee, shin, SACH foot

Facilitymedian $4,677 · 10th–90th $2,630–$7,7620%20%40%10th90th$4,677Professionalmedian $2,188 · 10th–90th $1,862–$3,9810%20%40%10th90th$2,188$5.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,137.96 / $3,548.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,137.96 / $3,715.35
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,677.35 / $9,549.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,630.27 / $5,754.40
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,715.35 / $5,248.07
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $3,981.07 / $5,888.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $2,754.23 / $2,884.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $2,754.23
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $2,754.23 / $2,754.23
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $2,754.23
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,388.44 / $4,897.79
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,370.32 / $5,370.32 / $5,370.32
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,265.80 / $5,011.87 / $9,120.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,311.31 / $4,570.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,187.76 / $3,019.95