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Texas rates for HCPCS L5200

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

Facilitymedian $3,467 · 10th–90th $1,995–$8,7100%10%20%10th90th$3,467Professionalmedian $2,188 · 10th–90th $1,862–$3,9810%50%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
$1,995.26 / $1,995.26 / $2,137.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,187.76 / $3,981.07
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $2,187.76
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,235.94 / $3,467.37 / $4,677.35
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $4,677.35 / $4,677.35
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
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $21,379.62 / $21,379.62
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24,547.09 / $29,512.09 / $29,512.09
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $3,548.13 / $5,888.44
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,238.72 / $4,786.30
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,630.27 / $2,691.53
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $3,467.37 / $5,888.44
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $2,754.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $3,019.95 / $4,570.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,454.71 / $3,019.95
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $4,677.35 / $4,677.35