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Arizona rates for HCPCS L5658

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

Facilitymedian $372 · 10th–90th $138–$9550%10%10th90th$372Professionalmedian $263 · 10th–90th $186–$4900%20%10th90th$263$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
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $263.03 / $457.09
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $489.78 / $912.01
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $446.68 / $870.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $363.08
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $331.13 / $2,344.23
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $218.78 / $2,884.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $338.84 / $371.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $218.78 / $331.13