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New York rates for HCPCS L5230

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

Facilitymedian $3,548 · 10th–90th $1,995$8,3180%10%20%10th90th$3,548Professionalmedian $2,754 · 10th–90th $1,995$6,3100%20%40%10th90th$2,754$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
$1,659.59 / $3,715.35 / $5,248.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,454.71 / $4,073.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $4,677.35 / $9,332.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $2,884.03 / $7,244.36
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,801.89 / $3,801.89
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $3,801.89 / $3,801.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $6,606.93
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $7,762.47 / $17,782.79
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $4,677.35 / $8,912.51
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $2,290.87
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,754.23 / $2,884.03
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $4,466.84 / $4,466.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $3,467.37 / $12,882.50
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $3,019.95 / $7,585.78
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,630.27 / $2,754.23
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,754.23 / $2,884.03