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Virginia rates for HCPCS L5655

Addition to lower extremity, socket insert, below knee (BK) (Kemblo, Pelite, Aliplast, Plastazote or equal)

Facilitymedian $347 · 10th–90th $178–$4370%20%40%10th90th$347Professionalmedian $191 · 10th–90th $162–$3310%20%40%10th90th$191$0.5$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
$177.83 / $177.83 / $177.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $177.83 / $257.04
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $363.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $416.87
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $234.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $218.78 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $218.78
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $346.74 / $478.63
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $223.87 / $338.84
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $245.47 / $446.68
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $223.87 / $245.47
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $281.84 / $1,000.00
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $281.84 / $1,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $239.88 / $346.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $169.82 / $269.15