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New Jersey rates for HCPCS L5637

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

Rates data updated July 2026.

How much does HCPCS L5637 cost?

$209

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $209 for this service. The price depends on where it is billed: about $209 from a physician practice, and about $162 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 5 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$209$178 to $282
FacilityA hospital or hospital-owned outpatient department$162$162 to $263

How much rates vary

Facilitymedian $162 · 10th to 90th $162 to $447Professionalmedian $209 · 10th to 90th $148 to $447
$50$100$200$500$1K$2Kfacility $162professional $209

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
$162.18
Median
$162.18
Typical High
$162.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$190.55
Typical High
$281.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$234.42
Typical High
$446.68
Cigna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$234.42
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$426.58
Typical High
$588.84
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$446.68
United
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$269.15
Typical High
$446.68
United
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$263.03
Typical High
$436.52

Where New Jersey 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.

New Jersey· 39th of 51

$209

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.