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North Carolina 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 $1,862 · 10th–90th $1,096–$4,7860%20%10th90th$1,862Professionalmedian $1,820 · 10th–90th $1,072–$1,9500%20%40%10th90th$1,820$1.0$5.0$20.0$100.0$500.0$2.0K$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
$1,819.70 / $1,819.70 / $1,819.70
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,737.80 / $1,949.84
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $2,398.83
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $1,862.09 / $2,041.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,778.28 / $1,778.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,288.25 / $1,949.84
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,513.56 / $1,621.81
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $2,041.74 / $3,467.37
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
$1,174.90 / $1,819.70 / $1,995.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,202.26 / $1,862.09
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13,182.57 / $13,182.57 / $13,182.57
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,848.93 / $15,848.93 / $20,417.38