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Pennsylvania rates for HCPCS L5638

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

Facilitymedian $676 · 10th–90th $257$1,0000%20%10th90th$676Professionalmedian $316 · 10th–90th $257$5890%20%40%10th90th$316$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
$257.04 / $1,000.00 / $1,000.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $309.03 / $524.81
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
$588.84 / $588.84 / $588.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $724.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $501.19
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $933.25 / $1,348.96
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $602.56
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $416.87 / $602.56
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $309.03 / $524.81
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $1,000.00 / $1,380.38
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $562.34
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $741.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $794.33 / $912.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $354.81 / $630.96