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Ohio rates for HCPCS L5695

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

Facilitymedian $209 · 10th–90th $123$3470%20%40%10th90th$209Professionalmedian $112 · 10th–90th $89$2000%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
$95.50 / $95.50 / $162.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $107.15 / $162.18
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $208.93 / $426.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $123.03 / $257.04
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $169.82 / $239.88
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $181.97 / $269.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $128.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $123.03
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $123.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $120.23 / $169.82
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $239.88
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $223.87 / $407.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $158.49 / $223.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $97.72 / $151.36