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New Jersey rates for HCPCS L5974

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

Facilitymedian $162 · 10th–90th $102–$2880%20%40%10th90th$162Professionalmedian $166 · 10th–90th $110–$2820%10%20%10th90th$166$100.0$200.0$500.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $158.49 / $239.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $173.78 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $173.78
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $263.03 / $389.05
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $208.93 / $323.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $165.96 / $281.84