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Pennsylvania rates for HCPCS L5624

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

Facilitymedian $513 · 10th–90th $219–$8320%20%10th90th$513Professionalmedian $240 · 10th–90th $195–$4070%20%40%10th90th$240$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$218.78 / $831.76 / $831.76
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $239.88 / $380.19
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87
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
$269.15 / $398.11 / $501.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $309.03
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $676.08 / $977.24
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $501.19
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $346.74 / $501.19
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $389.05
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $218.78
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $239.88 / $346.74
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $691.83 / $1,000.00
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $467.74
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $467.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $588.84 / $676.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $275.42 / $512.86