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New Jersey rates for HCPCS L5685

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

Facilitymedian $55 · 10th–90th $55–$1550%50%90th$55Professionalmedian $78 · 10th–90th $59–$1510%10%10th90th$78$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $74.13 / $128.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $154.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $100.00
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $141.25 / $208.93
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $104.71 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $91.20 / $147.91