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Wisconsin rates for HCPCS L5649

Addition to lower extremity, ischial containment/narrow M-L socket

Facilitymedian $3,020 · 10th–90th $2,455–$5,4950%20%40%10th90th$3,020Professionalmedian $1,995 · 10th–90th $1,230–$4,4670%20%10th90th$1,995$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$1,479.11 / $1,479.11 / $1,479.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,479.11 / $2,454.71
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,019.95 / $5,011.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $3,311.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $6,918.31 / $14,791.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $4,265.80 / $5,754.40
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,454.71 / $3,715.35
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $3,548.13 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,951.21 / $12,022.64
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,698.24 / $3,311.31
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $1,584.89
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,786.30 / $4,786.30 / $4,786.30
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,388.44 / $5,888.44
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $4,570.88 / $7,244.36
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $6,025.60 / $12,022.64
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,511.89 / $14,454.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,698.24 / $3,019.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,479.11 / $2,454.71