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South Carolina rates for HCPCS L5685

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

Facilitymedian $105 · 10th–90th $69–$1950%10%20%10th90th$105Professionalmedian $78 · 10th–90th $65–$1260%20%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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $69.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $77.62 / $114.82
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $141.25 / $158.49
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $154.88 / $186.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $177.83
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $77.62
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $112.20 / $245.47
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $44.67
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $104.71
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $104.71 / $186.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $77.62 / $104.71