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Pennsylvania 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 $1,318–$5,1290%20%10th90th$3,388Professionalmedian $1,479 · 10th–90th $1,288–$2,6300%20%40%10th90th$1,479$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
$1,318.26 / $5,128.61 / $5,128.61
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,479.11 / $2,570.40
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
$1,659.59 / $2,398.83 / $3,019.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $3,019.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $1,905.46
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,890.45 / $5,754.40
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,019.95 / $3,019.95
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,089.30 / $3,019.95
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $1,318.26
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,548.82 / $2,570.40
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $3,981.07 / $5,754.40
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $2,818.38
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $2,818.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $3,981.07 / $4,570.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,698.24 / $3,019.95