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Below-Knee Suspension/Sealing Sleeve

Maine rates for HCPCS L5685

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

Rates data updated July 2026.

How much does Below-Knee Suspension/Sealing Sleeve cost?

$102

Typical negotiated rate. In Maine, July 2026.

Insurers have agreed to pay about $102 for this service. The price depends on where it is billed: about $100 from a physician practice, and about $178 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 6 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$100$83.18 to $132
FacilityA hospital or hospital-owned outpatient department$178$110 to $178

How much rates vary

Facilitymedian $178 · 10th to 90th $100 to $204Professionalmedian $100 · 10th to 90th $66 to $132
$50$100$200facility $178professional $100

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$83.18
Typical High
$102.33
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$177.83
Typical High
$204.17
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$154.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$100.00
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$131.83
Typical High
$158.49
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$83.18
Typical High
$102.33
United
Setting
Facility
Modifier
Global
Typical Low
$43.65
Median
$91.20
Typical High
$109.65
United
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$131.83
Typical High
$131.83

Where Maine sits

The same service costs 2.3 times more in Wisconsin than in Nebraska. 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.

Maine· 17th of 51

$102

WI $158NE $67.61

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.