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Illinois rates for HCPCS L5972

All lower extremity prostheses, foot, flexible keel

Facilitymedian $537 · 10th–90th $234–$2,4550%20%10th90th$537Professionalmedian $275 · 10th–90th $200–$4900%20%10th90th$275$0.5$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$234.42 / $234.42 / $489.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $245.47 / $489.78
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $933.25 / $3,311.31
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $512.86
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $524.81 / $676.08
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $616.60
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $389.05
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $389.05 / $691.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $239.88 / $398.11