go back

Wisconsin rates for HCPCS L5613

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

Facilitymedian $3,020 · 10th–90th $2,692–$5,4950%20%40%10th90th$3,020Professionalmedian $2,455 · 10th–90th $1,380–$4,4670%20%10th90th$2,455$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
$1,479.11 / $1,479.11 / $1,479.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,698.24 / $2,630.27
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,019.95 / $4,897.79
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $3,388.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $6,918.31 / $14,791.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $4,265.80 / $5,623.41
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,630.27 / $3,715.35
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,691.53 / $3,890.45 / $4,786.30
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,951.21 / $15,488.17
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,949.84 / $3,630.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $1,995.26
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,786.30 / $4,786.30 / $4,786.30
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,388.44 / $5,888.44
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $4,677.35 / $9,332.54
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $6,025.60 / $18,620.87
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,754.23 / $18,620.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,187.76 / $3,019.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,659.59 / $2,511.89