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Wisconsin rates for HCPCS L5976

All lower extremity prostheses, energy storing foot (Seattle Carbon Copy II or equal)

Facilitymedian $724 · 10th–90th $589–$1,3180%20%40%10th90th$724Professionalmedian $537 · 10th–90th $331–$1,0960%20%10th90th$537$1.0$5.0$20.0$100.0$500.0$2.0K

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
$354.81 / $354.81 / $354.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $363.08 / $588.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $1,202.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $676.08 / $812.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $1,659.59 / $3,548.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $1,023.29 / $1,380.38
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $588.84 / $891.25
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $977.24 / $1,230.27
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $707.95 / $3,548.13
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $467.74 / $831.76
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $478.63
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,148.15 / $1,148.15
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $812.83 / $1,412.54
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,096.48 / $2,089.30
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $1,445.44 / $4,265.80
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $616.60 / $5,011.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $501.19 / $724.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $371.54 / $588.84