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Pennsylvania rates for HCPCS L5642

Addition to lower extremity, above knee (AK), leather socket

Facilitymedian $851 · 10th–90th $331–$1,2880%20%10th90th$851Professionalmedian $389 · 10th–90th $324–$6760%20%40%10th90th$389$1.0$10.0$100.0$1.0K$10.0K

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
$331.13 / $1,288.25 / $1,288.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $389.05 / $645.65
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
$416.87 / $602.56 / $758.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $389.05 / $524.81
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,174.90 / $1,737.80
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $758.58
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $537.03 / $758.58
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $331.13
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $389.05 / $645.65
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $1,202.26 / $1,737.80
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $707.95
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $776.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $1,000.00 / $1,174.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $446.68 / $812.83