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New York rates for HCPCS L5975

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

Facilitymedian $437 · 10th–90th $234$1,0000%20%10th90th$437Professionalmedian $302 · 10th–90th $240$8130%20%10th90th$302$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
$199.53 / $436.52 / $630.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $275.42 / $436.52
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $1,122.02
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $912.01
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $457.09 / $457.09
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $457.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $645.65
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $912.01 / $2,137.96
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $562.34 / $1,071.52
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $436.52
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $346.74 / $416.87
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $537.03 / $537.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $371.54 / $1,513.56
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $363.08 / $933.25
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $436.52
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $346.74 / $416.87