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Ohio rates for HCPCS L5658

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

Facilitymedian $589 · 10th–90th $288–$9770%20%40%10th90th$589Professionalmedian $275 · 10th–90th $195–$4900%20%10th90th$275$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
$269.15 / $269.15 / $436.52
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $251.19 / $380.19
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $588.84 / $1,202.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $338.84 / $724.44
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $371.54 / $524.81
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $389.05 / $588.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $380.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $363.08
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $363.08
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $331.13 / $478.63
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $676.08
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $630.96 / $1,148.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $363.08 / $562.34
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $269.15 / $346.74