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Missouri rates for HCPCS L5781

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

Facilitymedian $3,890 · 10th–90th $2,344–$9,7720%20%10th90th$3,890Professionalmedian $2,692 · 10th–90th $2,042–$4,5710%20%10th90th$2,692$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
$2,187.76 / $3,235.94 / $3,235.94
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,511.89 / $4,570.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $4,897.79 / $16,982.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,884.03 / $4,466.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $2,951.21 / $4,897.79
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $3,019.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $2,884.03
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,890.45 / $10,715.19
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,398.83 / $24,547.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $3,890.45 / $3,890.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,398.83 / $3,548.13