go back

North Carolina rates for HCPCS L5637

Addition to lower extremity, below knee (BK), total contact

Rates data updated July 2026.

How much does HCPCS L5637 cost?

$257

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $257 for this service. The price depends on where it is billed: about $257 from a physician practice, and about $282 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$257$224 to $263
FacilityA hospital or hospital-owned outpatient department$282$240 to $389

How much rates vary

Facilitymedian $282 · 10th to 90th $166 to $692Professionalmedian $257 · 10th to 90th $158 to $263
$200$500$1K$2Kfacility $282professional $257

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$257.04
Aetna
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$257.04
Typical High
$257.04
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$263.03
Typical High
$316.23
BCBS
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$346.74
Typical High
$691.83
BCBS
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$263.03
Typical High
$295.12
Cigna
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$234.42
Typical High
$245.47
Cigna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$269.15
Medcost
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$229.09
Typical High
$275.42
Medcost
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$295.12
Typical High
$524.81
United
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$275.42
Typical High
$354.81
United
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$173.78
Typical High
$269.15
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$1,995.26
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$2,344.23
Median
$2,344.23
Typical High
$3,311.31

Where North Carolina sits

The same service costs 2.7 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

North Carolina· 20th of 51

$257

HI $490DE $182

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.