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Wisconsin rates for HCPCS L5795

Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)

Facilitymedian $1,318 · 10th–90th $1,148$2,3990%50%10th90th$1,318Professionalmedian $1,023 · 10th–90th $631$1,9500%20%10th90th$1,023$1.0$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
$645.65 / $645.65 / $645.65
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $741.31 / $1,288.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $2,187.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $1,445.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $3,019.95 / $6,456.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,862.09 / $2,511.89
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $1,071.52 / $1,621.81
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,288.25 / $1,548.82
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $1,288.25 / $6,760.83
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $851.14 / $1,479.11
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $870.96
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $2,089.30
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,479.11 / $2,570.40
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,041.74 / $4,073.80
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $2,630.27 / $6,760.83
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,318.26 / $8,511.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $977.24 / $1,318.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $645.65 / $1,071.52