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Pennsylvania rates for HCPCS L5321

Above knee (AK), molded socket, open end, SACH foot, endoskeletal system, single axis knee

Facilitymedian $5,012 · 10th–90th $1,778–$6,7610%20%10th90th$5,012Professionalmedian $2,089 · 10th–90th $1,738–$3,6310%20%10th90th$2,089$1.0$10.0$100.0$1.0K$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
$1,778.28 / $6,760.83 / $6,760.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,089.30 / $3,630.78
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $3,388.44 / $3,388.44
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,235.94 / $3,981.07
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,454.71 / $3,981.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,819.70 / $2,454.71
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $5,248.07 / $7,585.78
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,818.38 / $3,981.07
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $2,754.23 / $3,235.94
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $1,778.28
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,041.74 / $3,388.44
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $6,165.95
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $3,715.35
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $3,801.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $5,370.32 / $6,165.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,238.72 / $3,981.07