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Wisconsin rates for HCPCS L5971

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

Facilitymedian $269 · 10th–90th $240$4900%50%10th90th$269Professionalmedian $195 · 10th–90th $120$3980%20%10th90th$195$0.2$1.0$5.0$20.0$100.0$500.0

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
$131.83 / $131.83 / $131.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $134.90 / $218.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $436.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $251.19 / $302.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $616.60 / $1,318.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $380.19 / $501.19
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $218.78 / $331.13
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $263.03 / $316.23
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $263.03 / $1,288.25
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $173.78 / $302.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $204.17
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $426.58
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $302.00 / $524.81
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $398.11 / $758.58
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $537.03 / $1,445.44
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $234.42 / $1,479.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $181.97 / $269.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $131.83 / $218.78