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New York rates for HCPCS L5637

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

Facilitymedian $363 · 10th–90th $191$7590%10%20%10th90th$363Professionalmedian $219 · 10th–90th $162$6170%20%10th90th$219$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
$162.18 / $354.81 / $645.65
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $213.80 / $354.81
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $263.03
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $912.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $707.95
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $371.54 / $371.54
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $371.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $537.03
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $741.31 / $1,737.80
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $446.68 / $851.14
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $354.81
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $281.84 / $338.84
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $851.14
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $436.52 / $436.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $263.03 / $1,071.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $288.40 / $741.31
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $275.42 / $354.81
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $281.84 / $338.84