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Wisconsin rates for HCPCS L5654

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

Facilitymedian $479 · 10th–90th $398–$8710%20%40%10th90th$479Professionalmedian $331 · 10th–90th $200–$7240%20%10th90th$331$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
$239.88 / $239.88 / $239.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $239.88 / $398.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $794.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $446.68 / $537.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $1,122.02 / $2,398.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $691.83 / $912.01
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $389.05 / $602.56
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $575.44 / $724.44
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $478.63 / $2,089.30
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $281.84 / $537.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $269.15
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $758.58
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $549.54 / $954.99
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $724.44 / $1,258.93
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $954.99 / $2,344.23
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $446.68 / $2,344.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $302.00 / $478.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $234.42 / $407.38