go back

Pennsylvania rates for HCPCS L5968

Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature

Facilitymedian $4,571 · 10th–90th $1,905–$7,4130%20%10th90th$4,571Professionalmedian $2,138 · 10th–90th $1,820–$3,7150%20%40%10th90th$2,138$1.0$10.0$100.0$1.0K$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
$1,905.46 / $7,413.10 / $7,413.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,137.96 / $3,715.35
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,715.35 / $3,715.35
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,467.37 / $4,365.16
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,454.71 / $3,890.45
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $2,454.71
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $5,754.40 / $8,317.64
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,365.16 / $4,365.16 / $4,365.16
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $3,090.30 / $4,365.16
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,388.44 / $3,388.44
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,905.46
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,137.96 / $3,311.31
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $6,165.95 / $8,511.38
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,090.30 / $4,073.80
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,090.30 / $4,168.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $5,370.32 / $6,165.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,398.83 / $4,365.16