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Alaska rates for HCPCS L5703

Ankle, Symes, molded to patient model, socket without solid ankle cushion heel (SACH) foot, replacement only

Facilitymedian $1,660 · 10th–90th $813–$2,8180%20%40%10th90th$1,660Professionalmedian $1,905 · 10th–90th $1,349–$3,9810%10%10th90th$1,905$100.0$200.0$500.0$1.0K$2.0K$5.0K$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
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,778.28 / $2,818.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,137.96 / $2,137.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $3,388.44
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $1,949.84 / $2,754.23
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,818.38 / $8,912.51
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,818.38 / $2,951.21
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,818.38 / $2,951.21
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $2,884.03
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $2,137.96 / $2,818.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $1,905.46
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,412.54 / $6,025.60