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South Carolina rates for HCPCS L5613

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

Facilitymedian $2,089 · 10th–90th $1,349–$4,1690%10%20%10th90th$2,089Professionalmedian $1,585 · 10th–90th $1,288–$2,5700%20%10th90th$1,585$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
$1,348.96 / $1,348.96 / $1,348.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,584.89 / $2,454.71
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $3,019.95 / $3,548.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,905.46 / $2,089.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $3,388.44
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,479.11 / $1,778.28
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $2,290.87 / $4,897.79
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $954.99
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $2,041.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,187.76 / $3,981.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,479.11 / $2,187.76