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Virginia rates for HCPCS L5975

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

Facilitymedian $562 · 10th–90th $288–$6920%20%40%10th90th$562Professionalmedian $302 · 10th–90th $245–$5130%50%10th90th$302$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
$288.40 / $288.40 / $288.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $288.40 / $436.52
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $588.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $630.96
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $380.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $363.08 / $363.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $363.08
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $562.34 / $776.25
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $363.08 / $549.54
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $398.11 / $645.65
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $338.84 / $363.08
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $457.09 / $1,288.25
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $457.09 / $1,288.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $371.54 / $676.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $275.42 / $436.52