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New Jersey rates for HCPCS L5658

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

Facilitymedian $224 · 10th–90th $174–$4790%20%40%10th90th$224Professionalmedian $263 · 10th–90th $182–$4680%10%10th90th$263$200.0$500.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $173.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $218.78 / $380.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $363.08 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $363.08
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $457.09 / $645.65
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $467.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $331.13 / $501.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $281.84 / $457.09