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Pennsylvania rates for HCPCS L5200

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

Facilitymedian $4,571 · 10th–90th $1,778–$6,9180%20%10th90th$4,571Professionalmedian $2,138 · 10th–90th $1,778–$3,7150%20%10th90th$2,138$1.0$10.0$100.0$1.0K$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
$1,778.28 / $6,918.31 / $6,918.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,137.96 / $3,715.35
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $3,235.94 / $4,073.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $2,754.23 / $4,073.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $2,754.23
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $5,248.07 / $7,762.47
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,073.80 / $4,073.80
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,818.38 / $4,073.80
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $1,778.28
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,187.76 / $3,715.35
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $5,370.32 / $7,762.47
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $3,801.89
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $3,801.89 / $4,168.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $5,370.32 / $6,165.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,344.23 / $4,073.80