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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.

Facilitymedian $115 · 10th–90th $69$2630%20%10th90th$115Professionalmedian $115 · 10th–90th $68$1200%50%10th90th$115$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
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