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Michigan rates for HCPCS L5230

Above knee (AK), for proximal femoral focal deficiency, constant friction knee, shin, SACH foot

Facilitymedian $6,166 · 10th–90th $3,311–$19,4980%20%10th90th$6,166Professionalmedian $2,818 · 10th–90th $2,042–$5,7540%20%10th90th$2,818$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$3,311.31 / $5,623.41 / $6,309.57
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,754.23 / $3,801.89
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $17,378.01 / $33,113.11
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,754.40 / $5,754.40 / $6,025.60
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,951.21 / $2,951.21 / $2,951.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $2,884.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,884.03 / $5,623.41
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $10,471.29 / $12,302.69
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $4,570.88 / $7,079.46
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $2,884.03
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $3,715.35 / $5,128.61
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $4,677.35 / $6,165.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,691.53 / $3,890.45