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Illinois rates for HCPCS L5595

Preparatory, hip disarticulation/hemipelvectomy, pylon, no cover, SACH foot, thermoplastic or equal, molded to patient model

Facilitymedian $6,166 · 10th–90th $2,754–$28,8400%20%10th90th$6,166Professionalmedian $2,818 · 10th–90th $2,188–$5,6230%20%10th90th$2,818$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$2,754.23 / $2,754.23 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,754.23 / $5,370.32
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $10,715.19 / $38,018.94
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $5,370.32
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,630.27 / $5,623.41
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,677.35 / $8,912.51 / $10,715.19
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,244.36 / $7,244.36 / $7,244.36
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,090.30 / $4,466.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,235.94 / $4,466.84 / $7,943.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,754.23 / $4,570.88