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South Carolina rates for HCPCS L5658

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

Facilitymedian $331 · 10th–90th $195–$6170%10%20%10th90th$331Professionalmedian $251 · 10th–90th $191–$3800%10%20%10th90th$251$50.0$100.0$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
$194.98 / $194.98 / $194.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $251.19 / $371.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $436.52 / $512.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $363.08 / $407.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $602.56
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $275.42
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $346.74 / $707.95
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $295.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $331.13 / $588.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $218.78 / $331.13