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Above Knee (AK), Proximal Femoral Focal Deficiency

Pennsylvania rates for HCPCS L5230

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

Rates data updated July 2026.

How much does Above Knee (AK), Proximal Femoral Focal Deficiency cost?

$2,291

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $2,291 for this service. The price depends on where it is billed: about $2,239 from a physician practice, and about $7,244 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 9 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$2,239$2,042 to $3,090
FacilityA hospital or hospital-owned outpatient department$7,244$2,188 to $10,233

How much rates vary

Facilitymedian $7,244 · 10th to 90th $2,042 to $16,218Professionalmedian $2,239 · 10th to 90th $1,862 to $3,981
$10.0$100.0$1.0K$10.0Kfacility $7,244professional $2,239

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$2,041.74
Typical High
$7,943.28
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,778.28
Median
$2,238.72
Typical High
$3,801.89
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$2,570.40
Median
$3,715.35
Typical High
$4,677.35
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,884.03
Median
$2,884.03
Typical High
$7,244.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2,089.30
Median
$2,089.30
Typical High
$2,884.03
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$4,265.80
Median
$6,165.95
Typical High
$8,912.51
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$4,677.35
Median
$4,677.35
Typical High
$4,677.35
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$2,818.38
Median
$3,235.94
Typical High
$4,677.35
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$2,041.74
Typical High
$7,943.28
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$1,949.84
Median
$2,238.72
Typical High
$3,801.89
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$2,398.83
Median
$2,398.83
Typical High
$2,398.83
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$5,370.32
Median
$11,220.18
Typical High
$17,782.79
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$2,187.76
Median
$4,365.16
Typical High
$4,466.84
United
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$6,165.95
Typical High
$6,165.95
United
Setting
Professional
Modifier
Global
Typical Low
$2,041.74
Median
$2,691.53
Typical High
$4,786.30

Where Pennsylvania sits

The same service costs 3.5 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Pennsylvania $2,291 · 48th of 51
HI $7,079DE $2,042

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.