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North Carolina rates for HCPCS L5631

Addition to lower extremity, above knee (AK) or knee disarticulation, acrylic socket

Facilitymedian $417 · 10th–90th $240–$1,0470%20%10th90th$417Professionalmedian $389 · 10th–90th $234–$4170%20%40%10th90th$389$0.5$5.0$50.0$500.0$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
$389.05 / $389.05 / $389.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $346.74 / $416.87
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $478.63
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $446.68
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $331.13 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $398.11
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $354.81 / $426.58
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $446.68 / $812.83
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $398.11 / $426.58
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $263.03 / $407.38
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $2,818.38
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $5,248.07