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Washington rates for HCPCS L5971

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

Facilitymedian $295 · 10th–90th $191–$6460%20%10th90th$295Professionalmedian $191 · 10th–90th $117–$3980%10%20%10th90th$191$1.0$5.0$20.0$100.0$500.0$2.0K

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
$190.55 / $190.55 / $457.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $144.54 / $245.47
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $288.40 / $288.40
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $331.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $158.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $158.49
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $363.08 / $831.76
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $346.74 / $562.34
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $223.87 / $245.47
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $288.40 / $295.12
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $295.12 / $295.12
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $426.58 / $588.84
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $288.40
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $331.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $398.11 / $398.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $162.18 / $234.42
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $257.04 / $446.68