go back

Wisconsin rates for HCPCS L5637

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

Facilitymedian $468 · 10th–90th $380$8510%20%40%10th90th$468Professionalmedian $269 · 10th–90th $174$6760%20%10th90th$269$0.5$2.0$10.0$50.0$200.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $234.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $234.42 / $389.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $776.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $436.52 / $512.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $1,096.48 / $2,290.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $676.08 / $891.25
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $380.19 / $588.84
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $562.34 / $691.83
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $457.09 / $1,949.84
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $263.03 / $501.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $269.15
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $741.31 / $741.31
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $537.03 / $933.25
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $707.95 / $1,096.48
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $933.25 / $2,187.76
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $338.84 / $2,290.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $263.03 / $467.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $229.09 / $380.19