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New York rates for HCPCS L5500

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

Facilitymedian $1,202 · 10th–90th $646$2,8180%20%10th90th$1,202Professionalmedian $1,047 · 10th–90th $676$2,3990%20%10th90th$1,047$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
$562.34 / $1,230.27 / $1,778.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $831.76 / $1,513.56
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,584.89 / $3,162.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,445.44 / $2,884.03
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,288.25 / $1,288.25
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,288.25 / $1,288.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $2,041.74
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,570.40 / $6,025.60
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,584.89 / $3,019.95
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $676.08
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $933.25 / $977.24
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,513.56 / $1,513.56
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $1,148.15 / $4,365.16
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $1,023.29 / $2,570.40
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $891.25 / $933.25
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $933.25 / $977.24