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Below-Knee Suspension/Sealing Sleeve

Utah 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 $91 · 10th–90th $45$1550%20%40%10th90th$91Professionalmedian $95 · 10th–90th $45$6610%10%20%10th90th$95$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
$44.67
Median
$44.67
Typical High
$44.67
Aetna
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$67.61
Typical High
$660.69
Cigna
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$100.00
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$114.82
Typical High
$147.91
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$154.88
Typical High
$154.88
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$112.20
Typical High
$169.82
Select Health
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$158.49
Select Health
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$154.88
Typical High
$158.49
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$158.49
Typical High
$186.21
United
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$91.20
Typical High
$109.65
United
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$69.18
Typical High
$107.15