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New York rates for HCPCS L5658

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

Facilitymedian $363 · 10th–90th $204–$8710%20%10th90th$363Professionalmedian $269 · 10th–90th $191–$6920%20%10th90th$269$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$173.78 / $380.19 / $537.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $245.47 / $398.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $954.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $776.25
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $389.05 / $389.05
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $389.05 / $389.05
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $630.96
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $794.33 / $1,819.70
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $478.63 / $912.01
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $263.03
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $281.84 / $302.00
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $457.09 / $457.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $331.13 / $1,348.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $309.03 / $794.33
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $281.84 / $295.12
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $281.84 / $302.00