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Indiana rates for HCPCS L5781

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

Facilitymedian $4,898 · 10th–90th $2,291–$6,0260%50%10th90th$4,898Professionalmedian $2,399 · 10th–90th $2,089–$4,0740%50%10th90th$2,399$5.0$20.0$100.0$500.0$2.0K$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
$2,290.87 / $2,290.87 / $2,290.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,344.23 / $3,630.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $4,897.79 / $6,165.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,884.03 / $4,897.79
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $6,309.57 / $7,244.36
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $4,897.79
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $4,265.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $3,311.31 / $3,981.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,398.83 / $3,467.37