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Nebraska rates for HCPCS L5613

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

Facilitymedian $3,388 · 10th–90th $1,950–$15,4880%10%10th90th$3,388Professionalmedian $2,291 · 10th–90th $1,230–$9,5500%10%10th90th$2,291$1.0K$2.0K$5.0K$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
$2,290.87 / $2,290.87 / $2,290.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $2,290.87 / $16,982.44
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $2,754.23 / $2,754.23
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,467.37 / $3,467.37
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $3,981.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $3,890.45 / $6,025.60
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $3,890.45 / $15,488.17
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,949.84 / $3,548.13
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,981.07 / $9,549.93
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,912.51 / $9,549.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,187.76 / $3,388.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,778.28 / $2,818.38