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Ohio rates for HCPCS L5624

Addition to lower extremity, test socket, above knee (AK)

Facilitymedian $513 · 10th–90th $288–$8510%20%10th90th$513Professionalmedian $251 · 10th–90th $200–$4680%20%10th90th$251$0.5$2.0$10.0$50.0$200.0$1.0K

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
$234.42 / $234.42 / $363.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $239.88 / $363.08
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $512.86 / $1,047.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $288.40 / $630.96
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $407.38
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $371.54 / $524.81
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $389.05 / $588.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $309.03
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $323.59
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $371.54 / $537.03
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $588.84
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $549.54 / $1,023.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $363.08 / $501.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $239.88 / $338.84