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Texas 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 $2,291 · 10th–90th $1,318–$5,7540%10%20%10th90th$2,291Professionalmedian $1,445 · 10th–90th $1,072–$2,6300%20%40%10th90th$1,445$2.0$10.0$50.0$200.0$1.0K$5.0K$20.0K

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 / $1,318.26 / $1,445.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,445.44 / $2,570.40
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $3,090.30 / $3,090.30
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $2,041.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,288.25 / $1,778.28
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13,182.57 / $13,182.57 / $13,182.57
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,848.93 / $20,417.38 / $20,417.38
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $2,290.87 / $3,801.89
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,445.44 / $2,951.21
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $1,698.24
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $2,290.87 / $3,801.89
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,288.25 / $1,778.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,862.09 / $2,818.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,479.11 / $1,862.09
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $3,090.30 / $3,090.30