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Michigan rates for HCPCS L5703

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

Facilitymedian $3,388 · 10th–90th $1,738–$12,3030%20%10th90th$3,388Professionalmedian $1,549 · 10th–90th $1,175–$3,0200%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
$1,737.80 / $1,737.80 / $1,737.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,479.11 / $1,995.26
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $9,120.11 / $17,378.01
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,019.95 / $3,162.28
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $1,737.80
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 / $2,137.96 / $3,090.30
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $5,754.40 / $6,456.54
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,454.71 / $3,715.35
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,137.96 / $2,137.96
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,187.76 / $2,818.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,511.89 / $3,388.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,445.44 / $2,041.74