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North Carolina rates for HCPCS L5974

All lower extremity prostheses, foot, single axis ankle/foot

Facilitymedian $229 · 10th–90th $126–$6170%20%10th90th$229Professionalmedian $209 · 10th–90th $120–$2340%50%10th90th$209$0.2$2.0$20.0$200.0$2.0K$20.0K

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
$208.93 / $208.93 / $208.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $204.17 / $234.42
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $234.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $173.78 / $173.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $218.78
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $158.49 / $239.88
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $245.47 / $426.58
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $208.93 / $229.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $138.04 / $213.80
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $1,548.82
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $2,187.76