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New York rates for HCPCS L5699

All lower extremity prostheses, shoulder harness

Facilitymedian $178 · 10th–90th $100$4170%20%10th90th$178Professionalmedian $138 · 10th–90th $100$3390%20%10th90th$138$0.2$2.0$20.0$200.0$2.0K$20.0K

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
$83.18 / $181.97 / $263.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $125.89 / $194.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $467.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $398.11
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $190.55 / $190.55
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $288.40
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $380.19 / $891.25
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $234.42 / $446.68
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $131.83
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $138.04 / $144.54
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $223.87 / $223.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $169.82 / $645.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $151.36 / $389.05
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $138.04 / $141.25
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $138.04 / $144.54