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Pennsylvania rates for HCPCS L5654

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

Facilitymedian $457 · 10th–90th $178$6920%20%10th90th$457Professionalmedian $224 · 10th–90th $170$3980%20%10th90th$224$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
$177.83 / $691.83 / $691.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $223.87 / $346.74
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
$223.87 / $323.59 / $407.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $426.58
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $309.03
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $562.34 / $812.83
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $407.38
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $281.84 / $407.38
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $218.78 / $316.23
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $575.44 / $831.76
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $380.19
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $309.03 / $446.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $537.03 / $616.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $234.42 / $426.58