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New York rates for HCPCS L5985

All endoskeletal lower extremity prostheses, dynamic prosthetic pylon

Facilitymedian $257 · 10th–90th $148$6170%20%10th90th$257Professionalmedian $186 · 10th–90th $148$5010%20%10th90th$186$0.2$2.0$20.0$200.0$2.0K$20.0K

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
$123.03 / $275.42 / $389.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $165.96 / $275.42
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $691.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $562.34
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $281.84 / $281.84
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $398.11
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $575.44 / $1,318.26
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $346.74 / $660.69
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $229.09
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $218.78 / $218.78
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $331.13 / $331.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $229.09 / $933.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $223.87 / $575.44
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $213.80 / $229.09
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $218.78 / $218.78