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Pennsylvania rates for HCPCS L5971

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

Facilitymedian $331 · 10th–90th $117–$4570%20%10th90th$331Professionalmedian $132 · 10th–90th $105–$2400%20%10th90th$132$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
$117.49 / $457.09 / $457.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $128.82 / $213.80
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
$263.03 / $263.03 / $263.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $251.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $158.49
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $323.59 / $467.74
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $186.21 / $269.15
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $117.49
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $131.83 / $204.17
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $346.74 / $478.63
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $190.55 / $251.19
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $190.55 / $309.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $331.13 / $380.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $147.91 / $251.19