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Below-Knee Suspension/Sealing Sleeve

North Dakota 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 $115$1950%50%90th$115Professionalmedian $145 · 10th–90th $83$1910%20%10th90th$145$50.0$100.0$200.0$500.0

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
$128.82
Aetna
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$114.82
Typical High
$575.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$173.78
Typical High
$190.55
Cigna
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$177.83
Typical High
$223.87
Medica
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$128.82
Typical High
$338.84
Medica
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$77.62
Typical High
$154.88
United
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$91.20
Typical High
$223.87
United
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$104.71
Typical High
$181.97