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New Jersey rates for HCPCS L5230

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

Facilitymedian $2,692 · 10th–90th $1,660–$4,6770%20%40%10th90th$2,692Professionalmedian $2,630 · 10th–90th $1,778–$4,5710%10%10th90th$2,630$2.0K$5.0K$10.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $1,659.59
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,238.72 / $4,365.16
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,884.03 / $4,677.35
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $2,884.03
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $4,265.80 / $6,309.57
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,570.88 / $4,570.88 / $4,570.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,467.37 / $5,248.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,754.23 / $4,570.88