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Indiana rates for HCPCS L5695

Addition to lower extremity, above knee (AK), pelvic control, sleeve suspension, neoprene or equal, each

Facilitymedian $200 · 10th–90th $93–$2510%20%40%10th90th$200Professionalmedian $112 · 10th–90th $91–$1620%20%10th90th$112$0.2$1.0$5.0$20.0$100.0$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
$93.33 / $93.33 / $93.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $104.71 / $151.36
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $199.53 / $251.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $120.23 / $199.53
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $263.03 / $302.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $147.91 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $97.72 / $151.36