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California rates for HCPCS L5685

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

Facilitymedian $79 · 10th–90th $63$3630%20%10th90th$79Professionalmedian $87 · 10th–90th $68$5620%20%10th90th$87$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
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $660.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $81.28 / $575.44
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $117.49 / $158.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $79.43 / $338.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $95.50 / $239.88
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $223.87 / $354.81
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $281.84 / $562.34
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
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $100.00 / $186.21
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $138.04 / $251.19
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $741.31 / $741.31
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,122.02 / $1,122.02
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $229.09
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $147.91 / $199.53
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $147.91
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $104.71 / $138.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.48 / $91.20 / $186.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $83.18 / $165.96