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Nebraska 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 $1,622–$13,1830%20%10th90th$2,754Professionalmedian $1,622 · 10th–90th $912–$6,7610%10%10th90th$1,622$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
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,621.81 / $1,621.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,621.81 / $12,589.25
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,454.71 / $2,454.71
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
$2,137.96 / $3,467.37 / $4,786.30
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,818.38 / $13,182.57
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,548.82 / $2,511.89
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $2,754.23 / $6,760.83
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $2,818.38
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,467.37 / $6,309.57 / $6,760.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,949.84 / $2,884.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,258.93 / $1,995.26