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Texas rates for HCPCS L5781

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

Facilitymedian $3,802 · 10th–90th $2,138–$9,7720%20%10th90th$3,802Professionalmedian $2,291 · 10th–90th $2,089–$4,0740%50%10th90th$2,291$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
$2,137.96 / $2,137.96 / $2,290.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,344.23 / $4,265.80
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,290.87 / $2,290.87
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $4,897.79 / $4,897.79
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $2,884.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $2,884.03
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22,908.68 / $22,908.68 / $22,908.68
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24,547.09 / $35,481.34 / $35,481.34
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,890.45 / $6,165.95
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,398.83 / $4,677.35
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,715.35 / $6,309.57
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $2,884.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $3,388.44 / $5,011.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,630.27 / $3,311.31
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $4,897.79 / $4,897.79