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Indiana rates for HCPCS L5699

All lower extremity prostheses, shoulder harness

Facilitymedian $251 · 10th–90th $117–$3160%20%40%10th90th$251Professionalmedian $126 · 10th–90th $110–$2040%20%40%10th90th$126$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
$117.49 / $117.49 / $117.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $120.23 / $204.17
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $251.19 / $316.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $138.04 / $251.19
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $371.54 / $426.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $251.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $213.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $169.82 / $199.53
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $123.03 / $177.83