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Illinois rates for HCPCS L5975

All lower extremity prostheses, combination single axis ankle and flexible keel foot

Facilitymedian $631 · 10th–90th $275–$2,8840%20%10th90th$631Professionalmedian $295 · 10th–90th $240–$5750%20%40%10th90th$295$0.5$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$275.42 / $275.42 / $575.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $288.40 / $549.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,096.48 / $3,890.45
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $616.60
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $616.60 / $776.25
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $724.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $489.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $457.09 / $812.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $281.84 / $467.74