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Texas rates for HCPCS L5673

Addition to lower extremity, below knee (BK)/above knee (AK), custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism

Facilitymedian $708 · 10th–90th $380–$1,8620%10%20%10th90th$708Professionalmedian $417 · 10th–90th $363–$7760%20%10th90th$417$1.0$5.0$20.0$100.0$500.0$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
$380.19 / $380.19 / $416.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $426.58 / $776.25
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $630.96 / $741.31
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,388.44 / $4,168.69
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $707.95 / $870.96
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,047.13 / $1,047.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $501.19
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $4,265.80
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,570.88 / $6,025.60 / $6,025.60
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $691.83 / $1,148.15
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $446.68 / $870.96
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $602.56
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $676.08 / $1,122.02
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $501.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $630.96 / $933.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $489.78 / $616.60
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $891.25 / $891.25