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North Carolina rates for HCPCS L5685

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

Facilitymedian $115 · 10th–90th $66$2630%20%10th90th$115Professionalmedian $102 · 10th–90th $66$1200%20%40%10th90th$102$0.1$1.0$10.0$100.0$1.0K$10.0K

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
$114.82 / $114.82 / $114.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $95.50 / $114.82
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $141.25 / $141.25
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $131.83
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 / $107.15
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $77.62 / $100.00
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $125.89 / $223.87
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $104.71 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $77.62 / $109.65
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $741.31 / $741.31
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $1,122.02