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Michigan rates for HCPCS L5985

All endoskeletal lower extremity prostheses, dynamic prosthetic pylon

Facilitymedian $417 · 10th–90th $195–$1,3800%10%10th90th$417Professionalmedian $195 · 10th–90th $148–$3390%20%10th90th$195$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
$194.98 / $194.98 / $194.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $173.78 / $257.04
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $1,023.29 / $1,949.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $354.81
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $223.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $218.78 / $380.19
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $645.65 / $724.44
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $269.15 / $416.87
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $218.78
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $239.88 / $338.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $275.42 / $416.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $162.18 / $239.88