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Pennsylvania rates for HCPCS L5978

All lower extremity prostheses, foot, multiaxial ankle/foot

Facilitymedian $407 · 10th–90th $155–$6030%20%10th90th$407Professionalmedian $186 · 10th–90th $151–$3470%20%10th90th$186$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
$154.88 / $602.56 / $602.56
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $181.97 / $316.23
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $354.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $245.47
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $467.74 / $676.08
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $251.19 / $354.81
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $181.97 / $316.23
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $478.63 / $691.83
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $331.13
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $338.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $478.63 / $549.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $204.17 / $354.81