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North Carolina rates for HCPCS L5500

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

Facilitymedian $1,175 · 10th–90th $692–$3,2360%20%10th90th$1,175Professionalmedian $1,148 · 10th–90th $676–$1,2880%20%40%10th90th$1,148$1.0$10.0$100.0$1.0K$10.0K$100.0K

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
$1,148.15 / $1,148.15 / $1,148.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,000.00 / $1,288.25
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,513.56
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,174.90 / $1,288.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $954.99 / $954.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $1,202.26
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $870.96 / $1,023.29
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $1,288.25 / $2,187.76
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $1,148.15 / $1,258.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $776.25 / $1,174.90
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,511.38 / $8,511.38 / $8,511.38
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,232.93 / $10,232.93 / $11,481.54