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New York rates for HCPCS L5974

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

Facilitymedian $219 · 10th–90th $112$5250%20%10th90th$219Professionalmedian $174 · 10th–90th $120$3800%20%40%10th90th$174$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
$102.33 / $223.87 / $316.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $162.18 / $239.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $575.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $177.83 / $446.68
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $234.42 / $234.42
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $234.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $323.59
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $467.74 / $1,096.48
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $288.40 / $537.03
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $117.49
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $169.82 / $177.83
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $275.42 / $275.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $208.93 / $794.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $186.21 / $467.74
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $158.49 / $169.82
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $169.82 / $177.83