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New Jersey rates for HCPCS L5636

Addition to lower extremity, Symes type, medial opening socket

Facilitymedian $151 · 10th–90th $148–$4070%20%40%10th90th$151Professionalmedian $178 · 10th–90th $132–$4070%10%10th90th$178$100.0$200.0$500.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $158.49 / $257.04
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $194.98
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $380.19 / $562.34
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $407.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $229.09 / $416.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $229.09 / $398.11