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Wisconsin 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 $3,467 · 10th–90th $2,818–$6,3100%50%10th90th$3,467Professionalmedian $2,399 · 10th–90th $1,380–$5,2480%20%10th90th$2,399$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
$1,698.24 / $1,698.24 / $1,698.24
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,698.24 / $2,818.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $3,467.37 / $5,754.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $3,235.94 / $3,801.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $7,943.28 / $16,982.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $4,897.79 / $6,606.93
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,818.38 / $4,265.80
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,090.30 / $4,168.69 / $5,248.07
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $3,388.44 / $14,791.08
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,041.74 / $3,801.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $1,905.46
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,495.41 / $5,495.41 / $5,495.41
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,890.45 / $6,760.83
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,467.37 / $5,248.07 / $8,912.51
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $6,918.31 / $17,782.79
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $2,570.40 / $18,197.01
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,137.96 / $3,467.37
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,698.24 / $2,818.38