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New Jersey rates for HCPCS L5430

Immediate postsurgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, above knee (AK) or knee disarticulation, each additional cast change and realignment

Facilitymedian $380 · 10th–90th $295–$8130%20%40%10th90th$380Professionalmedian $363 · 10th–90th $269–$5620%10%20%10th90th$363$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $363.08 / $549.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $812.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $426.58
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $758.58 / $1,096.48
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $537.03 / $537.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $457.09 / $812.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $457.09 / $794.33