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Pennsylvania rates for HCPCS L5972

All lower extremity prostheses, foot, flexible keel

Facilitymedian $575 · 10th–90th $186–$7240%20%10th90th$575Professionalmedian $234 · 10th–90th $186–$3980%20%40%10th90th$234$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
$186.21 / $724.44 / $724.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $234.42 / $398.11
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $346.74 / $426.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $426.58
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $295.12
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $562.34 / $812.83
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $426.58
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $302.00 / $426.58
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $223.87 / $354.81
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $575.44 / $831.76
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $398.11
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $912.01
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $575.44 / $660.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $245.47 / $426.58