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Wisconsin rates for HCPCS L5505

Initial, above knee (AK), knee disarticulation, ischial level socket, nonalignable system, pylon, no cover, SACH foot, plaster socket, direct formed

Facilitymedian $2,570 · 10th–90th $2,089–$4,6770%50%10th90th$2,570Professionalmedian $1,738 · 10th–90th $1,072–$3,8020%10%20%10th90th$1,738$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$1,258.93 / $1,258.93 / $1,258.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,258.93 / $2,089.30
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,570.40 / $4,168.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,398.83 / $2,818.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $5,888.44 / $12,589.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $3,630.78 / $4,786.30
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $2,041.74 / $3,162.28
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,511.89 / $3,019.95
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,511.89 / $11,220.18
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,513.56 / $2,818.38
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $1,412.54
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,073.80 / $4,073.80
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,884.03 / $5,011.87
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $3,801.89 / $6,606.93
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $5,128.61 / $13,182.57
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $2,344.23 / $13,803.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,584.89 / $2,570.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,258.93 / $2,089.30