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New York rates for HCPCS L5972

All lower extremity prostheses, foot, flexible keel

Facilitymedian $339 · 10th–90th $182$7760%20%10th90th$339Professionalmedian $269 · 10th–90th $186$5750%20%40%10th90th$269$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$154.88 / $338.84 / $489.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $234.42 / $380.19
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $870.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $281.84 / $676.08
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $354.81 / $354.81
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $549.54
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $707.95 / $1,659.59
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $426.58 / $812.83
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $316.23
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $269.15 / $302.00
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $426.58
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $416.87 / $416.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $316.23 / $1,202.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $281.84 / $707.95
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $263.03 / $316.23
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $269.15 / $302.00