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Pennsylvania rates for HCPCS L5637

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

Facilitymedian $468 · 10th–90th $182–$7080%20%10th90th$468Professionalmedian $209 · 10th–90th $162–$3890%20%10th90th$209$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
$181.97 / $707.95 / $707.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $208.93 / $302.00
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $354.81 / $354.81
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $407.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $371.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $234.42
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $588.84 / $851.14
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $288.40 / $416.87
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $309.03 / $331.13
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $181.97
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $199.53 / $275.42
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19,054.61 / $19,054.61 / $19,054.61
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $691.83
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $467.74 / $537.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $229.09 / $446.68