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Texas rates for HCPCS L5985

All endoskeletal lower extremity prostheses, dynamic prosthetic pylon

Facilitymedian $263 · 10th–90th $151$6920%10%20%10th90th$263Professionalmedian $166 · 10th–90th $145$3020%20%10th90th$166$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
$151.36 / $151.36 / $162.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $165.96 / $302.00
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $204.17
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $346.74 / $346.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $218.78
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,621.81 / $1,621.81
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,570.40 / $2,570.40
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $269.15 / $446.68
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $169.82 / $338.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $208.93
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $263.03 / $446.68
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $218.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $234.42 / $354.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $190.55 / $234.42
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $346.74 / $346.74