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Illinois rates for HCPCS L5658

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

Facilitymedian $617 · 10th–90th $269–$2,8180%20%10th90th$617Professionalmedian $269 · 10th–90th $191–$5620%20%10th90th$269$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
$269.15 / $269.15 / $562.34
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $269.15 / $489.78
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $1,071.52 / $3,801.89
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $575.44
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $537.03 / $660.69
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $446.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $446.68 / $707.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $275.42 / $446.68