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Molded Distal Cushion, Below-Knee

Pennsylvania rates for HCPCS L5668

Addition to lower extremity, below knee (BK), molded distal cushion

Rates data updated July 2026.

How much does Molded Distal Cushion, Below-Knee cost?

$64.57

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $64.57 for this service. The price depends on where it is billed: about $64.57 from a physician practice, and about $200 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 9 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$64.57$57.54 to $83.18
FacilityA hospital or hospital-owned outpatient department$200$64.57 to $372

How much rates vary

Facilitymedian $200 · 10th to 90th $55 to $631Professionalmedian $65 · 10th to 90th $50 to $115
$100$1K$10Kfacility $200professional $65

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$208.93
Aetna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$60.26
Typical High
$100.00
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$123.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$89.13
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$169.82
Typical High
$245.47
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$123.03
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$87.10
Typical High
$123.03
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$91.20
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$208.93
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$60.26
Typical High
$100.00
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$426.58
Typical High
$691.83
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$114.82
Typical High
$131.83
United
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$165.96
Typical High
$165.96
United
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$72.44
Typical High
$128.82

Where Pennsylvania sits

The same service costs 3.2 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 48th of 51

$64.57

HI $186DE $57.54

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.