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Georgia rates for HCPCS L5703

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

Facilitymedian $2,754 · 10th–90th $1,122–$10,2330%10%20%10th90th$2,754Professionalmedian $1,622 · 10th–90th $1,122–$2,6300%10%20%10th90th$1,622$2.0$10.0$50.0$200.0$1.0K$5.0K$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
$1,122.02 / $1,122.02 / $3,311.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,479.11 / $2,511.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $6,606.93 / $10,232.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $2,238.72 / $3,388.44
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,290.87 / $2,290.87
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,290.87 / $2,290.87
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 / $3,548.13
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,754.23 / $5,495.41
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $1,905.46 / $2,187.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,348.96 / $2,630.27