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Ohio rates for HCPCS L5985

All endoskeletal lower extremity prostheses, dynamic prosthetic pylon

Facilitymedian $363 · 10th–90th $204$6030%20%40%10th90th$363Professionalmedian $174 · 10th–90th $148$3020%20%40%10th90th$174$0.2$1.0$5.0$20.0$100.0$500.0

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
$165.96 / $165.96 / $281.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $165.96 / $281.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $363.08 / $741.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $208.93 / $446.68
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $288.40 / $407.38
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $309.03 / $467.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $218.78
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $218.78
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $218.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $208.93 / $295.12
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $389.05 / $724.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $257.04 / $354.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $169.82 / $234.42