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Illinois rates for HCPCS L5781

Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system

Facilitymedian $5,495 · 10th–90th $2,399–$25,1190%20%10th90th$5,495Professionalmedian $2,754 · 10th–90th $2,089–$4,8980%20%10th90th$2,754$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$2,398.83 / $2,398.83 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,511.89 / $4,786.30
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,754.40 / $9,332.54 / $33,113.11
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,630.78 / $3,630.78 / $3,630.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $5,370.32
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $5,248.07
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $5,370.32 / $6,760.83
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
$6,309.57 / $6,309.57 / $6,309.57
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $2,951.21 / $4,168.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $3,981.07 / $7,079.46
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,398.83 / $3,981.07