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Arizona rates for HCPCS L5685

Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each

Facilitymedian $123 · 10th–90th $45–$2950%10%10th90th$123Professionalmedian $79 · 10th–90th $65–$1380%20%40%10th90th$79$0.1$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
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $79.43 / $134.90
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $120.23
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $165.96 / $309.03
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $151.36 / $288.40
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $100.00
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $100.00 / $316.23
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $69.18 / $776.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $123.03 / $123.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $69.18 / $104.71