go back

Pennsylvania rates for HCPCS L5985

All endoskeletal lower extremity prostheses, dynamic prosthetic pylon

Facilitymedian $355 · 10th–90th $148–$5750%20%10th90th$355Professionalmedian $170 · 10th–90th $145–$2880%20%40%10th90th$170$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
$147.91 / $575.44 / $575.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $165.96 / $281.84
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $269.15 / $338.84
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
$316.23 / $457.09 / $660.69
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $239.88 / $338.84
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $169.82 / $281.84
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $478.63 / $676.08
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $316.23
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $309.03 / $323.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $416.87 / $478.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $186.21 / $346.74