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Michigan rates for HCPCS L5695

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

Facilitymedian $245 · 10th–90th $112–$7940%20%10th90th$245Professionalmedian $115 · 10th–90th $89–$1950%20%10th90th$115$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
$112.20 / $112.20 / $112.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $112.20 / $147.91
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $588.84 / $1,122.02
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $204.17
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $131.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $123.03 / $245.47
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $371.54 / $416.87
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $158.49 / $239.88
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $154.88 / $218.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $158.49 / $269.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $97.72 / $147.91