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New Jersey rates for HCPCS L5500

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

Facilitymedian $912 · 10th–90th $562–$1,5850%20%40%10th90th$912Professionalmedian $871 · 10th–90th $603–$1,5490%10%10th90th$871$200.0$500.0$1.0K$2.0K$5.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $562.34
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $758.58 / $1,479.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $954.99 / $1,584.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $954.99
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,445.44 / $2,137.96
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $1,548.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $1,148.15 / $1,778.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $912.01 / $1,548.82