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Wisconsin rates for HCPCS L5301

Below knee (BK), molded socket, shin, SACH foot, endoskeletal system

Facilitymedian $3,311 · 10th–90th $2,951–$6,0260%50%10th90th$3,311Professionalmedian $2,291 · 10th–90th $1,380–$4,8980%10%20%10th90th$2,291$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$1,621.81 / $1,621.81 / $1,621.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,621.81 / $2,818.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $3,311.31 / $5,495.41
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,090.30 / $3,715.35
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $7,585.78 / $16,218.10
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $4,677.35 / $6,309.57
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,691.53 / $4,073.80
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $3,981.07 / $5,011.87
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $3,235.94 / $14,791.08
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,949.84 / $3,630.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $2,187.76
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,248.07 / $5,248.07 / $5,248.07
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $3,715.35 / $6,456.54
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $4,897.79 / $8,709.64
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $6,606.93 / $17,378.01
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,511.89 / $17,378.01
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,089.30 / $3,311.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,621.81 / $2,754.23