go back

Texas rates for HCPCS L5703

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

Facilitymedian $2,512 · 10th–90th $1,349$5,6230%10%10th90th$2,512Professionalmedian $1,514 · 10th–90th $1,175$2,8180%20%40%10th90th$1,514$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
$1,412.54 / $1,412.54 / $1,513.56
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,513.56 / $2,630.27
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,905.46
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $3,235.94 / $3,235.94
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 / $2,137.96
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13,489.63 / $13,489.63 / $13,489.63
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,218.10 / $20,892.96 / $20,892.96
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $2,570.40 / $4,073.80
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,513.56 / $3,090.30
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $2,041.74
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $2,511.89 / $3,981.07
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $2,137.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,995.26 / $2,884.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,548.82 / $1,905.46
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $3,235.94 / $3,235.94