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Wisconsin rates for HCPCS L5701

Replacement, socket, above knee (AK)/knee disarticulation, including attachment plate, molded to patient model

Facilitymedian $4,677 · 10th–90th $3,890–$8,5110%20%40%10th90th$4,677Professionalmedian $3,467 · 10th–90th $1,905–$7,0790%20%10th90th$3,467$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$2,290.87 / $2,290.87 / $2,290.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,290.87 / $3,715.35
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $4,677.35 / $7,762.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $4,365.16 / $5,128.61
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $10,715.19 / $22,908.68
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $6,606.93 / $8,912.51
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $3,801.89 / $5,754.40
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $5,623.41 / $7,079.46
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $4,570.88 / $21,379.62
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,951.21 / $5,248.07
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $3,090.30
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $7,413.10 / $7,413.10
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $5,248.07 / $9,120.11
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,677.35 / $7,079.46 / $12,882.50
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $9,332.54 / $25,703.96
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $3,715.35 / $26,302.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $3,090.30 / $4,677.35
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,344.23 / $3,801.89