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Wisconsin rates for HCPCS L5678

Additions to lower extremity, below knee (BK), joint covers, pair

Facilitymedian $49 · 10th–90th $42–$890%20%40%10th90th$49Professionalmedian $36 · 10th–90th $22–$720%20%10th90th$36$0.1$0.2$1.0$5.0$20.0$100.0$500.0

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
$23.99 / $23.99 / $23.99
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $26.92 / $44.67
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $79.43
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $45.71 / $54.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$29.51 / $112.20 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $69.18 / $91.20
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.99 / $39.81 / $60.26
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $75.86 / $95.50
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.99 / $47.86 / $251.19
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $31.62 / $58.88
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.72 / $58.88 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $77.62
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $54.95 / $95.50
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $74.13 / $151.36
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$29.51 / $97.72 / $302.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $43.65 / $446.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $35.48 / $52.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $25.12 / $40.74