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Below-Knee Suspension/Sealing Sleeve

North Carolina 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?

$115

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $115 for this service. The price depends on where it is billed: about $115 from a physician practice, and about $115 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 7 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$115$81.28 to $120
FacilityA hospital or hospital-owned outpatient department$115$100 to $158

How much rates vary

Facilitymedian $115 · 10th to 90th $69 to $263Professionalmedian $115 · 10th to 90th $68 to $120
$0.1$1.0$10.0$100.0$1.0K$10.0Kfacility $115professional $115

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
Aetna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$114.82
Typical High
$114.82
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$141.25
BCBS
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$154.88
Typical High
$309.03
BCBS
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$131.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$104.71
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$107.15
Medcost
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$77.62
Typical High
$100.00
Medcost
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$125.89
Typical High
$223.87
United
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$125.89
Typical High
$158.49
United
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$77.62
Typical High
$109.65
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$741.31
Typical High
$741.31
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$794.33
Typical High
$1,122.02

Where North Carolina sits

The same service costs 2.3 times more in Wisconsin than in Nebraska. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

North Carolina $115 · 14th of 51
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.