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Wisconsin rates for HCPCS L5631

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

Facilitymedian $537 · 10th–90th $479–$9770%50%10th90th$537Professionalmedian $407 · 10th–90th $251–$8130%20%10th90th$407$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
$263.03 / $263.03 / $263.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $309.03 / $467.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $537.03 / $891.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $602.56
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $1,230.27 / $2,630.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $758.58 / $1,023.29
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $446.68 / $660.69
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $851.14 / $1,047.13
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $524.81 / $2,754.23
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $354.81 / $602.56
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $354.81
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $851.14
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $602.56 / $1,047.13
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $831.76 / $1,659.59
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $1,071.52 / $2,754.23
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $478.63 / $3,467.37
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $398.11 / $537.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $263.03 / $446.68