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Illinois rates for HCPCS L5694

Addition to lower extremity, above knee (AK), pelvic control belt, padded and lined

Facilitymedian $245 · 10th–90th $107–$1,1220%20%10th90th$245Professionalmedian $126 · 10th–90th $93–$2510%20%10th90th$126$0.2$1.0$5.0$20.0$100.0$500.0$2.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $223.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $123.03 / $223.87
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $426.58 / $1,513.56
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $165.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $239.88
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $257.04 / $323.59
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $165.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $177.83 / $354.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $109.65 / $181.97