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Virginia rates for HCPCS L5703

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

Facilitymedian $2,570 · 10th–90th $1,318–$3,2360%20%40%10th90th$2,570Professionalmedian $1,514 · 10th–90th $1,230–$2,5700%50%10th90th$1,514$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$1,318.26 / $1,348.96 / $1,348.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,348.96 / $1,995.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,570.40 / $2,691.53
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,513.56 / $3,162.28
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $1,737.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $2,137.96 / $2,137.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $1,548.82
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,570.40 / $3,548.13
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,698.24 / $1,698.24
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,905.46 / $3,162.28
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,659.59 / $1,737.80
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,137.96 / $5,623.41
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,137.96 / $5,623.41
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $1,905.46 / $3,388.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,258.93 / $1,995.26