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Ohio rates for HCPCS L5972

All lower extremity prostheses, foot, flexible keel

Facilitymedian $513 · 10th–90th $282–$8510%20%10th90th$513Professionalmedian $240 · 10th–90th $195–$4470%20%40%10th90th$240$0.5$2.0$10.0$50.0$200.0$1.0K

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 / $389.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $234.42 / $380.19
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $354.81 / $389.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $512.86 / $1,047.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $281.84 / $616.60
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $407.38
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $389.05 / $549.54
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $407.38 / $616.60
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $309.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $295.12
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $295.12
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $371.54 / $537.03
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $588.84
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $549.54 / $1,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $354.81 / $489.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $234.42 / $323.59