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Missouri rates for HCPCS L5613

Addition to lower extremity, endoskeletal system, above knee (AK), knee disarticulation, four-bar linkage, with hydraulic swing phase control

Facilitymedian $2,951 · 10th–90th $1,622–$6,7610%20%10th90th$2,951Professionalmedian $1,778 · 10th–90th $1,288–$3,3880%20%10th90th$1,778$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
$1,621.81 / $2,398.83 / $2,398.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,659.59 / $3,388.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,630.78 / $3,630.78 / $12,882.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $3,388.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $3,630.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,995.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $1,905.46
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,818.38 / $7,943.28
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,778.28 / $18,620.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,951.21 / $2,951.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,778.28 / $2,570.40