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California rates for HCPCS L5985

All endoskeletal lower extremity prostheses, dynamic prosthetic pylon

Facilitymedian $178 · 10th–90th $141$8130%20%10th90th$178Professionalmedian $186 · 10th–90th $148$1,2880%20%10th90th$186$0.2$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
$181.97 / $181.97 / $1,445.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $181.97 / $1,288.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $177.83 / $758.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $186.21 / $501.19
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $489.78 / $776.25
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $616.60 / $1,258.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $218.78 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $218.78
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $154.88 / $407.38
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $302.00 / $549.54
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,621.81 / $1,621.81
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,570.40 / $2,570.40
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $302.00 / $426.58
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $323.59
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $630.96
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $162.18 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $204.17 / $416.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $186.21 / $363.08