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Ohio rates for HCPCS L5654

Addition to lower extremity, socket insert, Symes, (Kemblo, Pelite, Aliplast, Plastazote or equal)

Facilitymedian $513 · 10th–90th $263–$8510%20%10th90th$513Professionalmedian $229 · 10th–90th $182–$4170%20%40%10th90th$229$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
$229.09 / $229.09 / $354.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $223.87 / $331.13
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $512.86 / $1,023.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $281.84 / $630.96
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $338.84 / $478.63
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $354.81 / $537.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $309.03
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $309.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $288.40 / $416.87
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $575.44
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $537.03 / $1,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $331.13 / $478.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $234.42 / $309.03