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South Carolina rates for HCPCS L5695

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

Facilitymedian $148 · 10th–90th $89–$2690%10%20%10th90th$148Professionalmedian $112 · 10th–90th $87–$1620%10%20%10th90th$112$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
$89.13 / $89.13 / $89.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $112.20 / $147.91
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $204.17 / $239.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $123.03 / $134.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $229.09
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $138.04
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $165.96 / $346.74
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $63.10
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $134.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $147.91 / $269.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $100.00 / $147.91