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California rates for HCPCS L5658

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

Facilitymedian $251 · 10th–90th $200$1,1480%20%10th90th$251Professionalmedian $269 · 10th–90th $191$1,7380%20%10th90th$269$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
$263.03 / $263.03 / $1,949.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $263.03 / $1,737.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $251.19 / $1,071.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $269.15 / $707.95
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $660.69 / $1,071.52
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $831.76 / $1,698.24
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $363.08 / $363.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $363.08
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $169.82 / $549.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $446.68 / $758.58
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,344.23 / $2,344.23
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $3,548.13 / $3,548.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $436.52
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $436.52 / $616.60
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $549.54
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $851.14
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $177.83 / $416.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $288.40 / $588.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $263.03 / $501.19