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Wisconsin rates for HCPCS L5230

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

Facilitymedian $5,888 · 10th–90th $4,786–$10,7150%20%40%10th90th$5,888Professionalmedian $3,802 · 10th–90th $2,188–$8,7100%20%10th90th$3,802$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
$2,884.03 / $2,884.03 / $2,884.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,884.03 / $4,466.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,888.44 / $5,888.44 / $9,772.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,897.79 / $5,495.41 / $6,456.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $13,489.63 / $28,840.32
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $8,317.64 / $11,220.18
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $4,786.30 / $7,244.36
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $5,754.40 / $6,918.31
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $5,754.40 / $24,547.09
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $3,311.31 / $6,456.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $3,162.28
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,332.54 / $9,332.54 / $9,332.54
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $6,606.93 / $11,481.54
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,888.44 / $8,709.64 / $14,454.40
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $11,748.98 / $28,840.32
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $4,168.69 / $30,199.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,467.37 / $5,888.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,884.03 / $4,897.79