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New York rates for HCPCS L5978

All lower extremity prostheses, foot, multiaxial ankle/foot

Facilitymedian $275 · 10th–90th $151$6460%20%10th90th$275Professionalmedian $219 · 10th–90th $151$5250%20%10th90th$219$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
$128.82 / $281.84 / $398.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $194.98 / $354.81
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $707.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $602.56
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $295.12 / $295.12
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $436.52
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $588.84 / $1,380.38
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $354.81 / $676.08
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $158.49
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $208.93 / $223.87
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $338.84 / $338.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $263.03 / $1,000.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $234.42 / $588.84
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $199.53 / $208.93
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $208.93 / $223.87