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New York rates for HCPCS L5971

All lower extremity prostheses, solid ankle cushion heel (SACH) foot, replacement only

Facilitymedian $195 · 10th–90th $107–$4470%20%10th90th$195Professionalmedian $148 · 10th–90th $107–$3630%20%40%10th90th$148$0.2$2.0$20.0$200.0$2.0K$20.0K

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
$89.13 / $194.98 / $275.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $138.04 / $218.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $501.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $416.87
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $204.17 / $204.17
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $204.17
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $302.00
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $407.38 / $954.99
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $251.19 / $467.74
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $186.21
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $154.88 / $177.83
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $239.88 / $239.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $181.97 / $691.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $162.18 / $407.38
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $147.91 / $186.21
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $154.88 / $177.83