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Illinois rates for HCPCS L5703

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

Facilitymedian $3,467 · 10th–90th $1,514–$15,8490%20%10th90th$3,467Professionalmedian $1,549 · 10th–90th $1,175–$3,0900%20%10th90th$1,549$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
$1,513.56 / $1,513.56 / $3,090.30
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,513.56 / $2,818.38
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,630.78 / $5,888.44 / $20,892.96
BCBS
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 / $2,818.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $3,311.31
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $3,311.31 / $4,168.69
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $2,818.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,511.89 / $4,073.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,513.56 / $2,454.71