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Nebraska rates for HCPCS L5658

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

Facilitymedian $501 · 10th–90th $288–$2,3440%10%20%10th90th$501Professionalmedian $339 · 10th–90th $182–$1,4130%10%20%10th90th$339$200.0$500.0$1.0K$2.0K

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
$338.84 / $338.84 / $338.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $338.84 / $1,949.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $512.86 / $512.86
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
$363.08 / $630.96 / $891.25
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $575.44 / $2,344.23
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $288.40 / $524.81
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $1,412.54
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $588.84
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,318.26 / $1,412.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $331.13 / $501.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $263.03 / $407.38