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New Jersey rates for HCPCS L5985

All endoskeletal lower extremity prostheses, dynamic prosthetic pylon

Facilitymedian $123 · 10th–90th $123–$3470%20%40%90th$123Professionalmedian $170 · 10th–90th $132–$3390%10%20%10th90th$170$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $158.49 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $346.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $218.78
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $316.23 / $467.74
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $229.09 / $354.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $204.17 / $331.13