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Pennsylvania rates for HCPCS L5699

All lower extremity prostheses, shoulder harness

Facilitymedian $269 · 10th–90th $100$3890%20%10th90th$269Professionalmedian $120 · 10th–90th $100$2040%20%40%10th90th$120$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
$100.00 / $389.05 / $389.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $120.23 / $204.17
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $199.53 / $229.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $234.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $169.82
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $302.00 / $446.68
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $229.09
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $158.49 / $229.09
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $120.23 / $194.98
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $309.03 / $446.68
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $213.80
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $213.80 / $309.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $302.00 / $346.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $138.04 / $234.42