go back

North Carolina rates for HCPCS L5500

Initial, below knee (BK) PTB type socket, nonalignable system, pylon, no cover, SACH foot, plaster socket, direct formed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,147.32 / $1,147.32 / $2,328.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$689.59 / $1,147.32 / $1,147.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,404.32 / $2,286.59 / $2,816.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,073.19 / $1,156.11 / $1,156.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$953.54 / $963.22 / $963.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$703.15 / $963.22 / $2,064.00
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$496.48 / $1,147.32 / $1,735.94
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$867.00 / $867.00 / $1,082.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,849.80 / $1,849.80 / $2,844.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$640.87 / $772.30 / $1,206.50
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,990.79 / $9,722.68 / $9,722.68
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,112.74 / $10,112.74 / $11,561.25