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Pennsylvania rates for HCPCS L5595

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

Facilitymedian $5,495 · 10th–90th $2,239–$8,7100%20%10th90th$5,495Professionalmedian $2,692 · 10th–90th $2,188–$4,7860%20%10th90th$2,692$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
$2,238.72 / $8,709.64 / $8,709.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,630.27 / $4,265.80
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
$5,128.61 / $5,128.61 / $5,128.61
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $5,495.41
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,630.27 / $3,548.13
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,011.87 / $7,079.46 / $10,232.93
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,128.61 / $5,128.61 / $5,128.61
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,630.78 / $5,128.61
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,238.72 / $2,238.72
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,691.53 / $4,265.80
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $7,244.36 / $10,471.29
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,398.83 / $4,786.30
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,398.83 / $5,248.07
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $6,606.93 / $7,585.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,884.03 / $5,495.41