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Ohio rates for HCPCS L5638

Addition to lower extremity, below knee (BK), leather socket

Facilitymedian $832 · 10th–90th $389–$1,3490%20%40%10th90th$832Professionalmedian $389 · 10th–90th $263–$6610%20%10th90th$389$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
$380.19 / $380.19 / $489.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $346.74 / $512.86
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $831.76 / $1,698.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $467.74 / $1,023.29
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $512.86 / $724.44
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $549.54 / $812.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $501.19
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $501.19
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $501.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $478.63 / $676.08
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $954.99
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $891.25 / $1,621.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $489.78 / $794.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $380.19 / $489.78