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South Carolina rates for HCPCS L5694

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

Facilitymedian $155 · 10th–90th $98–$3090%10%20%10th90th$155Professionalmedian $120 · 10th–90th $93–$1860%10%20%10th90th$120$50.0$100.0$200.0$500.0$1.0K

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
$97.72 / $97.72 / $97.72
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $120.23 / $186.21
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $218.78 / $257.04
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $141.25 / $154.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $251.19
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $144.54
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $169.82 / $363.08
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $70.79
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $147.91
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $162.18 / $295.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $109.65 / $162.18