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Missouri rates for HCPCS L5570

Preparatory, above knee (AK), knee disarticulation, ischial level socket, nonalignable system, pylon, no cover, SACH foot, thermoplastic or equal, direct formed

Facilitymedian $2,344 · 10th–90th $1,318–$5,4950%20%10th90th$2,344Professionalmedian $1,479 · 10th–90th $1,148–$2,7540%20%10th90th$1,479$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
$1,318.26 / $1,949.84 / $1,949.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,445.44 / $2,754.23
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,951.21 / $2,951.21 / $10,232.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,479.11 / $2,691.53
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $2,951.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $1,862.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,288.25 / $1,778.28
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $2,290.87 / $6,456.54
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,445.44 / $15,488.17
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,344.23 / $2,344.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,412.54 / $2,137.96