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New York rates for HCPCS L5580

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

Facilitymedian $2,344 · 10th–90th $1,349–$5,7540%20%10th90th$2,344Professionalmedian $1,820 · 10th–90th $1,288–$4,2660%20%40%10th90th$1,820$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
$1,148.15 / $2,511.89 / $3,548.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,584.89 / $2,511.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $6,309.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,862.09 / $4,786.30
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,570.40 / $2,570.40
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,570.40 / $2,570.40
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,288.25 / $3,981.07
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $5,248.07 / $12,302.69
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $3,162.28 / $6,025.60
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $2,089.30
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $1,949.84 / $1,995.26
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $3,019.95 / $3,019.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $2,137.96 / $8,709.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $2,041.74 / $5,370.32
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,862.09 / $1,949.84 / $2,089.30
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $1,949.84 / $1,995.26