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New York rates for HCPCS L5631

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

Facilitymedian $550 · 10th–90th $309–$1,2880%20%10th90th$550Professionalmedian $339 · 10th–90th $240–$9770%20%10th90th$339$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
$257.04 / $562.34 / $794.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $309.03 / $446.68
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $398.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $1,445.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $1,096.48
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $588.84 / $588.84
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $588.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $691.83
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $1,174.90 / $2,754.23
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $724.44 / $1,348.96
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $478.63
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $446.68 / $457.09
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $575.44
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $691.83 / $691.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $398.11 / $1,621.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $446.68 / $1,230.27
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $436.52 / $478.63
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $446.68 / $457.09