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Pennsylvania 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 $3,236 · 10th–90th $1,259–$4,8980%20%10th90th$3,236Professionalmedian $1,514 · 10th–90th $1,230–$2,8180%20%10th90th$1,514$1.0$10.0$100.0$1.0K$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
$1,258.93 / $4,897.79 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,513.56 / $2,511.89
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,290.87 / $2,884.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $2,818.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,288.25 / $1,778.28
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $4,168.69 / $6,025.60
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $2,884.03
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,041.74 / $2,884.03
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,258.93
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,479.11 / $2,398.83
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $4,265.80 / $6,165.95
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $2,691.53
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $2,951.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $3,890.45 / $4,466.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,659.59 / $3,019.95