Hospital

Geisinger Encompass Health Rehabilitation Hospital

Danville, PA · CCN 393047 · Rates published

1,539 distinct procedures filed

3 distinct payers

4,666 rate rows

2026-01-01 last MRF observed

Data quality

4,660 of 4,666 rate rows are consumer-grade (99.9%)

6 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
placeholder amount (≤ $0.02) — excluded from medians	6

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://edge.sitecorecloud.io/encompasshee178-encompasshed9db-prodb258-07da/media/Project/EncompassHealth/encompasshealth/Files/1-price-transparency/721398803_Geisinger-Encompass-Health-Rehabilitation-Hospital_standardcharges.csv
Found on page	https://www.encompasshealth.com/locations/geisinger/financial-information/price-transparency
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-08-12
Content fingerprint	801cbcfe297d6907… · 10,395,833 bytes · first seen 2026-05-14

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code	Description	Payers	Min $	Max $	Avg median	vs national
L7181 HCPCS	Electronic Elbo Simultaneous	3	$22,503.13	$28,128.91	$26,253.65	nat. median $50,516 0.5× median
L7180 HCPCS	Electronic Elbow Sequential	3	$19,974.96	$24,968.70	$23,304.12	nat. median $46,980 outlier · 0.5×
L5856 HCPCS	Elec Knee-shin Swing/stance	3	$13,482.22	$16,852.77	$15,729.25	nat. median $30,017 0.5× median
L8614 HCPCS	Cochlear Device	3	$11,155.75	$13,944.69	$13,015.04	nat. median $22,351 0.6× median
L5858 HCPCS	Stance Phase Only	3	$10,437.86	$13,047.32	$12,177.50	nat. median $23,237 0.5× median
L6975 HCPCS	Interscap-thor Myoelectronic	3	$10,115.66	$12,644.57	$11,801.60	nat. median $22,826 0.5× median
L5973 HCPCS	Ank-foot Sys Dors-plant Flex	3	$9,832.49	$12,290.61	$11,471.24	nat. median $21,726 0.5× median
L6970 HCPCS	Interscapular-thor Switch CT	3	$9,162.62	$11,453.27	$10,689.72	nat. median $20,980 0.5× median
L6965 HCPCS	Shldr Disartic Myoelectronic	3	$8,524.95	$10,656.19	$9,945.77	nat. median $19,981 outlier · 0.5×
L5859 HCPCS	Knee-shin Pro Flex/ext Cont	3	$8,148.75	$10,185.94	$9,506.88	nat. median $18,321 0.5× median
L6960 HCPCS	Shldr Disartic Switch Contro	3	$7,442.15	$9,302.68	$8,682.51	nat. median $16,650 0.5× median
L6955 HCPCS	Above Elbow Myoelectronic CT	3	$7,009.96	$8,762.45	$8,178.29	nat. median $15,745 0.5× median
L6945 HCPCS	Elbow Disart Myoelectronic C	3	$6,083.08	$7,603.85	$7,096.92	nat. median $13,912 0.5× median
L6950 HCPCS	Above Elbow Switch Control	3	$5,763.86	$7,204.82	$6,724.50	nat. median $12,858 0.5× median
L7191 HCPCS	Elbow Child Myoelectronic CT	3	$5,648.91	$7,061.14	$6,590.40	nat. median $13,827 outlier · 0.5×
L6940 HCPCS	Elbow Disarticulation Switch	3	$5,438.69	$6,798.37	$6,345.14	nat. median $12,193 0.5× median
L7186 HCPCS	Electron Elbow Child Switch	3	$5,244.64	$6,555.80	$6,118.74	nat. median $13,302 outlier · 0.5×
L6935 HCPCS	Below Elbow Myoelectronic CT	3	$4,936.60	$6,170.75	$5,759.37	nat. median $11,147 0.5× median
L6925 HCPCS	Wrist Disart Myoelectronic C	3	$4,834.44	$6,043.05	$5,640.18	nat. median $10,846 0.5× median
L8619 HCPCS	Replace Cochlear Processor	3	$4,789.09	$5,986.36	$5,587.27	nat. median $13,189 outlier · 0.4×
L5857 HCPCS	Elec Knee-shin Swing Only	3	$4,784.01	$5,980.01	$5,581.35	nat. median $10,749 0.5× median
L7190 HCPCS	Elbow Adolescent Myoelectron	3	$4,471.48	$5,589.35	$5,216.72	nat. median $10,857 outlier · 0.5×
L5701 HCPCS	Replace Socket Above Knee	3	$4,467.00	$5,583.75	$5,211.50	nat. median $4,549 1.1× median
L6920 HCPCS	Wrist Disarticul Switch Ctrl	3	$4,409.82	$5,512.27	$5,144.79	nat. median $9,420 0.5× median
L6930 HCPCS	Below Elbow Switch Control	3	$4,171.79	$5,214.74	$4,867.09	nat. median $9,632 0.5× median
L8627 HCPCS	Cid Ext Speech Process Repl	3	$4,091.42	$5,114.28	$4,773.33	nat. median $8,785 0.5× median
L5987 HCPCS	Shank Ft W Vert Load Pylon	3	$4,040.15	$5,050.19	$4,713.51	nat. median $8,991 0.5× median
L5649 HCPCS	Isch Containmt/narrow M-i So	3	$3,790.20	$4,737.75	$4,421.90	nat. median $2,968 1.5× median
81408 CDM	Mopath Procedure Level 9	3	$3,708.00	$4,635.00	$4,326.00	nat. median $4,326 1.0× median
L8609 HCPCS	Artificial Cornea	3	$3,659.21	$4,574.02	$4,269.08	nat. median $8,066 0.5× median
L2036 HCPCS	Kafo Plas Doub Free Knee Mol	3	$3,531.00	$4,413.75	$4,119.50	nat. median $2,509 1.6× median
L0486 HCPCS	Tlso Rigid Lined Cust Fab Two	3	$3,507.60	$4,384.50	$4,092.20	nat. median $2,644 1.5× median
L7008 HCPCS	Pediatric Electric Hand	3	$3,505.43	$4,381.78	$4,089.67	nat. median $7,523 0.5× median
L7185 HCPCS	Electron Elbow Adolescent Sw	3	$3,434.42	$4,293.02	$4,006.82	nat. median $9,262 outlier · 0.4×
L8682 HCPCS	Implt Neurostim Radiofq Rec	3	$3,362.12	$4,202.65	$3,922.48	nat. median $7,454 0.5× median
L7170 HCPCS	Electronic Elbow Hosmer Swit	3	$3,354.47	$4,193.09	$3,913.55	nat. median $9,290 outlier · 0.4×
L0484 HCPCS	Tlso Rigid Plastic Cust Fab	3	$3,297.00	$4,121.25	$3,846.50	nat. median $2,351 1.6× median
L5250 HCPCS	Hip Canad Sing Axi Cons Fric	3	$2,968.33	$3,710.41	$3,463.05	nat. median $7,091 outlier · 0.5×
L8683 HCPCS	Radiofq Trsmtr For Implt Neu	3	$2,959.43	$3,699.29	$3,452.67	nat. median $6,622 0.5× median
L5270 HCPCS	Tilt Table Locking Hip Sing	3	$2,942.32	$3,677.90	$3,432.71	nat. median $7,136 outlier · 0.5×
L5280 HCPCS	Hemipelvect Canad Sing Axis	3	$2,912.90	$3,641.13	$3,398.39	nat. median $7,340 outlier · 0.5×
L5341 HCPCS	Hemipelvectomy Canadian Sach	3	$2,891.33	$3,614.16	$3,373.22	nat. median $7,400 outlier · 0.5×
L4631 HCPCS	Afo, Walking Boot, Custom	3	$2,801.40	$3,501.75	$3,268.30	nat. median $1,951 1.7× median
L8690 HCPCS	Aud Osseo Dev, Int/ext Comp	3	$2,671.74	$3,339.68	$3,117.03	nat. median $5,649 0.6× median
L5331 HCPCS	Hip Disart Canadian Sach Ft	3	$2,660.69	$3,325.86	$3,104.14	nat. median $6,939 outlier · 0.4×
L6570 HCPCS	Scap Thorac Prosth Tiss Shap	3	$2,646.94	$3,308.68	$3,088.10	nat. median $6,005 0.5× median
L0464 HCPCS	Tlso 4mod Sacro-scap Pre	3	$2,643.00	$3,303.75	$3,083.50	nat. median $1,789 1.7× median
L5600 HCPCS	Hip Disart Sach Laminat Mold	3	$2,636.67	$3,295.84	$3,076.11	nat. median $5,933 0.5× median
L5961 HCPCS	Endo Poly Hip, Pneu/hyd/rot	3	$2,602.71	$3,253.39	$3,036.49	nat. median $6,009 0.5× median
L6205 HCPCS	Elbow Molded W/expand Inter	3	$2,600.77	$3,250.96	$3,034.23	nat. median $5,129 0.6× median

Other procedures at this hospital

Browse this hospital's 1,539 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

77301	CDM	Radiation Imr Plan	3	3	$3,787.00	$2,840.25 25% off	$2,272.20	$2,840.25	$2,650.90	2026-01-01
77385	CDM	Radiation Imrt Simple	3	3	$1,628.00	$1,221.00 25% off	$976.80	$1,221.00	$1,139.60	2026-01-01
77386	CDM	Radiation Imrt Complex	3	3	$1,617.00	$1,212.75 25% off	$970.20	$1,212.75	$1,131.90	2026-01-01
77470	CDM	Radiation Special Treatment	3	3	$1,617.00	$1,212.75 25% off	$970.20	$1,212.75	$1,131.90	2026-01-01
78306	CDM	Nm Bone Joint Image Whole Body	3	3	$1,851.00	$1,388.25 25% off	$1,110.60	$1,388.25	$1,295.70	2026-01-01
78580	CDM	Nm Pulmonary Perfusion	3	3	$1,882.00	$1,411.50 25% off	$1,129.20	$1,411.50	$1,317.40	2026-01-01
78582	CDM	Nm Pulm Perfusion With Ventilati	3	3	$2,219.00	$1,664.25 25% off	$1,331.40	$1,664.25	$1,553.30	2026-01-01
801	CDM	Hd Inhouse Tablo	6	3	$1,419.00	$1,064.25 25% off	$667.80	$1,293.75	$934.88	2026-01-01
81407	CDM	Mopath Procedure Level 8	3	3	$2,616.00	$1,962.00 25% off	$1,569.60	$1,962.00	$1,831.20	2026-01-01
81408	CDM	Mopath Procedure Level 9	3	3	$6,180.00	$4,635.00 25% off	$3,708.00	$4,635.00	$4,326.00	2026-01-01
87507	CDM	Iadna-dna/rna Probe Tq 12-25	3	3	$1,432.00	$1,074.00 25% off	$859.20	$1,074.00	$1,002.40	2026-01-01
87633	CDM	Resp Virus 12-25 Targets	3	3	$1,432.00	$1,074.00 25% off	$859.20	$1,074.00	$1,002.40	2026-01-01
90937	CDM	Peritoneal Dialysis	3	3	$2,550.00	$1,912.50 25% off	$1,530.00	$1,912.50	$1,785.00	2026-01-01
93978	CDM	US Aorta Duplex Complete	3	3	$1,447.00	$1,085.25 25% off	$868.20	$1,085.25	$1,012.90	2026-01-01
95816	CDM	EEG-awake And Drowsy	3	3	$1,561.00	$1,170.75 25% off	$936.60	$1,170.75	$1,092.70	2026-01-01
99283	CDM	Emergency Room-moderate	3	3	$3,653.00	$2,739.75 25% off	$2,191.80	$2,739.75	$2,557.10	2026-01-01
L0112	HCPCS	Cranial Cervical Orthosis	3	3	$1,307.54	$980.65 25% off	$784.52	$980.65	$915.28	2026-01-01
L0200	HCPCS	Cerv Col Supp Adj Bar & Thor	3	3	$1,646.00	$1,234.50 25% off	$987.60	$1,234.50	$1,152.20	2026-01-01
L0456	HCPCS	Tlso Flex Prefab	3	3	$2,947.00	$2,210.25 25% off	$1,768.20	$2,210.25	$2,062.90	2026-01-01
L0457	HCPCS	Tlso Flex Trnk Sj-ss Pre Ots	3	3	$2,947.00	$2,210.25 25% off	$1,768.20	$2,210.25	$2,062.90	2026-01-01
L0458	HCPCS	Tlso 2mod Symphis-xipho Pre	3	3	$2,643.00	$1,982.25 25% off	$1,585.80	$1,982.25	$1,850.10	2026-01-01
L0460	HCPCS	Tlso 2mod Symphsis-stern Pre	3	3	$2,975.00	$2,231.25 25% off	$1,785.00	$2,231.25	$2,082.50	2026-01-01
L0462	HCPCS	Tlso 3mod Sacro-scap Pre	3	3	$1,166.46	$874.85 25% off	$699.88	$874.85	$816.52	2026-01-01
L0464	HCPCS	Tlso 4mod Sacro-scap Pre	3	3	$4,405.00	$3,303.75 25% off	$2,643.00	$3,303.75	$3,083.50	2026-01-01
L0472	HCPCS	Tlso Rigid Frame Hyperex Pre	3	3	$1,301.00	$975.75 25% off	$780.60	$975.75	$910.70	2026-01-01
L0480	HCPCS	Tlso Rigid Plastic Custom Fa	3	3	$1,274.39	$955.79 25% off	$764.63	$955.79	$892.07	2026-01-01
L0482	HCPCS	Tlso Rigid Lined Custom Fab	3	3	$1,480.26	$1,110.19 25% off	$888.16	$1,110.19	$1,036.18	2026-01-01
L0484	HCPCS	Tlso Rigid Plastic Cust Fab	3	3	$5,495.00	$4,121.25 25% off	$3,297.00	$4,121.25	$3,846.50	2026-01-01
L0486	HCPCS	Tlso Rigid Lined Cust Fab Two	3	3	$5,846.00	$4,384.50 25% off	$3,507.60	$4,384.50	$4,092.20	2026-01-01
L0627	HCPCS	Lo Sagitt Rigid Panel Prefab	3	3	$1,218.00	$913.50 25% off	$730.80	$913.50	$852.60	2026-01-01
L0631	HCPCS	Lso Sag-coro Rigid Frame Prefb	3	3	$3,043.00	$2,282.25 25% off	$1,825.80	$2,282.25	$2,130.10	2026-01-01
L0636	HCPCS	Lso Sagittal Rigid Panel Cus	3	3	$1,268.18	$951.13 25% off	$760.91	$951.13	$887.73	2026-01-01
L0637	HCPCS	Lso Sag-coronal Panel Prefab	3	3	$3,521.00	$2,640.75 25% off	$2,112.60	$2,640.75	$2,464.70	2026-01-01
L0638	HCPCS	Lso Sag-coronal Panel Custom	3	3	$1,232.14	$924.11 25% off	$739.28	$924.11	$862.50	2026-01-01
L0640	HCPCS	Lso S/c Shell/panel Custom	3	3	$3,101.00	$2,325.75 25% off	$1,860.60	$2,325.75	$2,170.70	2026-01-01
L0642	HCPCS	Lo Sag Ri An/pos Pnl Pre Ots	3	3	$1,218.00	$913.50 25% off	$730.80	$913.50	$852.60	2026-01-01
L0648	HCPCS	Lso Sag R An/pos Pnl Pre Ots	3	3	$3,043.00	$2,282.25 25% off	$1,825.80	$2,282.25	$2,130.10	2026-01-01
L0650	HCPCS	Lso Sc R Ant/pos Pnl Pre Ots	3	3	$3,521.00	$2,640.75 25% off	$2,112.60	$2,640.75	$2,464.70	2026-01-01
L0700	HCPCS	Ctlso A-p-l Control Molded	3	3	$1,829.59	$1,372.19 25% off	$1,097.75	$1,372.19	$1,280.71	2026-01-01
L0710	HCPCS	Ctlso A-p-l Control W/inter	3	3	$1,869.16	$1,401.87 25% off	$1,121.50	$1,401.87	$1,308.41	2026-01-01
L0810	HCPCS	Halo Cervical Into Jckt Vest	3	3	$2,337.62	$1,753.21 25% off	$1,402.57	$1,753.21	$1,636.33	2026-01-01
L0820	HCPCS	Halo Cervical Into Body Jack	3	3	$2,098.17	$1,573.63 25% off	$1,258.90	$1,573.63	$1,468.72	2026-01-01
L0830	HCPCS	Halo Cerv Into Milwauee Typ	3	3	$2,956.93	$2,217.70 25% off	$1,774.16	$2,217.70	$2,069.85	2026-01-01
L0859	HCPCS	MRI Compatible System	3	3	$1,232.28	$924.21 25% off	$739.37	$924.21	$862.60	2026-01-01
L1000	HCPCS	Ctlso Milwauke Initial Model	3	3	$1,835.63	$1,376.72 25% off	$1,101.38	$1,376.72	$1,284.94	2026-01-01
L1005	HCPCS	Tension Based Scoliosis Orth	3	3	$2,990.08	$2,242.56 25% off	$1,794.05	$2,242.56	$2,093.06	2026-01-01
L1200	HCPCS	Furnish Initial Orthosis Only	3	3	$1,402.27	$1,051.70 25% off	$841.36	$1,051.70	$981.59	2026-01-01
L1300	HCPCS	Body Jacket Mold To Patient	3	3	$1,648.49	$1,236.37 25% off	$989.09	$1,236.37	$1,153.94	2026-01-01
L1310	HCPCS	Post-operative Body Jacket	3	3	$1,693.84	$1,270.38 25% off	$1,016.30	$1,270.38	$1,185.69	2026-01-01
L1680	HCPCS	Pelvic & Hip Control Thigh C	3	3	$1,090.46	$817.85 25% off	$654.28	$817.85	$763.32	2026-01-01
L1685	HCPCS	Post-op Hip Abduct Custom Fa	3	3	$1,112.87	$834.65 25% off	$667.72	$834.65	$779.01	2026-01-01
L1686	HCPCS	Ho Post-op Hip Abduction Prefb	3	3	$2,921.00	$2,190.75 25% off	$1,752.60	$2,190.75	$2,044.70	2026-01-01
L1690	HCPCS	Combination Bilateral Ho	3	3	$1,806.53	$1,354.90 25% off	$1,083.92	$1,354.90	$1,264.57	2026-01-01
L1700	HCPCS	Leg Perthes Orth Toronto Typ	3	3	$1,366.73	$1,025.05 25% off	$820.04	$1,025.05	$956.71	2026-01-01
L1710	HCPCS	Legg Perthes Orth Newington	3	3	$1,599.90	$1,199.92 25% off	$959.94	$1,199.92	$1,119.93	2026-01-01
L1720	HCPCS	Legg Perthes Orthosis Trilat	3	3	$1,179.33	$884.50 25% off	$707.60	$884.50	$825.53	2026-01-01
L1755	HCPCS	Legg Perthes Patten Bottom T	3	3	$1,607.45	$1,205.59 25% off	$964.47	$1,205.59	$1,125.21	2026-01-01
L1832	HCPCS	Ko Adj Jnt Pos Rigid Pre-fab	3	3	$2,014.00	$1,510.50 25% off	$1,208.40	$1,510.50	$1,409.80	2026-01-01
L1833	HCPCS	Ko Adj Jnt Pos R Sup Pre Ots	3	3	$2,014.00	$1,510.50 25% off	$1,208.40	$1,510.50	$1,409.80	2026-01-01
L1843	HCPCS	Ko Single Upright Custom Fit	3	3	$2,659.00	$1,994.25 25% off	$1,595.40	$1,994.25	$1,861.30	2026-01-01
L1844	HCPCS	Ko W/adj Jt Rot Contrl Molded	3	3	$1,452.92	$1,089.69 25% off	$871.75	$1,089.69	$1,017.04	2026-01-01
L1845	HCPCS	Ko W/adj Flex/ext Rotat Cus	3	3	$2,536.00	$1,902.00 25% off	$1,521.60	$1,902.00	$1,775.20	2026-01-01
L1907	HCPCS	Afo Supramalleolar Custom	3	3	$1,667.00	$1,250.25 25% off	$1,000.20	$1,250.25	$1,166.90	2026-01-01
L1920	HCPCS	Afo Sing Upright With Adjust S	3	3	$1,106.00	$829.50 25% off	$663.60	$829.50	$774.20	2026-01-01
L1932	HCPCS	Afo Rig Ant Tib Prefab Tcf/=	3	3	$2,644.00	$1,983.00 25% off	$1,586.40	$1,983.00	$1,850.80	2026-01-01
L1940	HCPCS	Afo Molded To Patient Plasti	3	3	$1,587.00	$1,190.25 25% off	$952.20	$1,190.25	$1,110.90	2026-01-01
L1945	HCPCS	Afo Molded Plas Rig Ant Tib	3	3	$2,972.00	$2,229.00 25% off	$1,783.20	$2,229.00	$2,080.40	2026-01-01
L1951	HCPCS	Afo Spiral Prefabricated	3	3	$2,489.00	$1,866.75 25% off	$1,493.40	$1,866.75	$1,742.30	2026-01-01
L1960	HCPCS	Afo Pos Solid Ank Plastic Mo	3	3	$1,774.00	$1,330.50 25% off	$1,064.40	$1,330.50	$1,241.80	2026-01-01
L1970	HCPCS	Afo Plastic Molded W/ankle J	3	3	$2,230.00	$1,672.50 25% off	$1,338.00	$1,672.50	$1,561.00	2026-01-01
L1971	HCPCS	Afo W/ankle Joint, Prefab	3	3	$1,389.00	$1,041.75 25% off	$833.40	$1,041.75	$972.30	2026-01-01
L1990	HCPCS	Afo Doub Solid Stirrup Calf	3	3	$1,446.00	$1,084.50 25% off	$867.60	$1,084.50	$1,012.20	2026-01-01
L2005	HCPCS	Kafo Sng/dbl Mechanical Act	3	3	$3,828.15	$2,871.11 25% off	$2,296.89	$2,871.11	$2,679.70	2026-01-01
L2020	HCPCS	Kafo Dbl Solid Stirrup Band/	3	3	$3,702.00	$2,776.50 25% off	$2,221.20	$2,776.50	$2,591.40	2026-01-01
L2034	HCPCS	Kafo Pla Sin Up W/wo K/a Cus	3	3	$1,903.47	$1,427.60 25% off	$1,142.08	$1,427.60	$1,332.43	2026-01-01
L2036	HCPCS	Kafo Plas Doub Free Knee Mol	3	3	$5,885.00	$4,413.75 25% off	$3,531.00	$4,413.75	$4,119.50	2026-01-01
L2037	HCPCS	Kafo Plas Sing Free Knee Mol	3	3	$1,605.35	$1,204.01 25% off	$963.21	$1,204.01	$1,123.74	2026-01-01
L2038	HCPCS	Kafo Without Joint Multi-axis An	3	3	$1,630.79	$1,223.09 25% off	$978.47	$1,223.09	$1,141.55	2026-01-01
L2114	HCPCS	Afo Tib Fx Semi-rigid	3	3	$1,858.00	$1,393.50 25% off	$1,114.80	$1,393.50	$1,300.60	2026-01-01
L2126	HCPCS	Kafo Fem Fx Cast Thermoplas	3	3	$1,176.49	$882.37 25% off	$705.89	$882.37	$823.54	2026-01-01
L2128	HCPCS	Kafo Fem Fx Cast Molded To Pt	3	3	$1,665.97	$1,249.48 25% off	$999.58	$1,249.48	$1,166.18	2026-01-01
L2136	HCPCS	Kafo Femoral Fx Cast Rigid	3	3	$1,150.38	$862.78 25% off	$690.23	$862.78	$805.27	2026-01-01
L2250	HCPCS	Foot Plate Molded Stirrup At	3	3	$1,116.00	$837.00 25% off	$669.60	$837.00	$781.20	2026-01-01
L2280	HCPCS	Molded Inner Boot	3	3	$1,408.00	$1,056.00 25% off	$844.80	$1,056.00	$985.60	2026-01-01
L2340	HCPCS	Pre-tibial Shell Molded To P	3	3	$1,425.00	$1,068.75 25% off	$855.00	$1,068.75	$997.50	2026-01-01
L2510	HCPCS	Th/wght Bear Quad-lat Brim M	3	3	$2,314.00	$1,735.50 25% off	$1,388.40	$1,735.50	$1,619.80	2026-01-01
L2525	HCPCS	Th/wght Bear Nar M-l Brim Mo	3	3	$1,161.47	$871.10 25% off	$696.88	$871.10	$813.03	2026-01-01
L2627	HCPCS	Plastic Mold Recipro Hip & C	3	3	$1,617.18	$1,212.88 25% off	$970.31	$1,212.88	$1,132.03	2026-01-01
L2628	HCPCS	Metal Frame Recipro Hip & Ca	3	3	$1,590.74	$1,193.06 25% off	$954.44	$1,193.06	$1,113.52	2026-01-01
L3760	HCPCS	Eo Withjoint, Prefabricated	3	3	$1,353.00	$1,014.75 25% off	$811.80	$1,014.75	$947.10	2026-01-01
L3763	HCPCS	Ewho Rigid Without Jnts Cf	3	3	$1,977.00	$1,482.75 25% off	$1,186.20	$1,482.75	$1,383.90	2026-01-01
L3764	HCPCS	Ewho W/joint(s) Cf	3	3	$2,256.00	$1,692.00 25% off	$1,353.60	$1,692.00	$1,579.20	2026-01-01
L3765	HCPCS	Ewhfo Rigid Without Jnts Cf	3	3	$1,090.18	$817.63 25% off	$654.11	$817.63	$763.13	2026-01-01
L3766	HCPCS	Ewhfo W/joint(s) Cf	3	3	$1,154.42	$865.82 25% off	$692.65	$865.82	$808.09	2026-01-01
L3806	HCPCS	Whfo W/joint(s) Custom Fab	3	3	$1,225.00	$918.75 25% off	$735.00	$918.75	$857.50	2026-01-01
L3900	HCPCS	Hinge Extension/flex Wrist/f	3	3	$1,239.71	$929.78 25% off	$743.83	$929.78	$867.80	2026-01-01
L3901	HCPCS	Hinge Ext/flex Wrist Finger	3	3	$1,407.84	$1,055.88 25% off	$844.70	$1,055.88	$985.49	2026-01-01
L3904	HCPCS	Whfo Electric Custom Fitted	3	3	$2,564.67	$1,923.50 25% off	$1,538.80	$1,923.50	$1,795.27	2026-01-01
L3905	HCPCS	Who W/nontorsion Jnt(s) Cf	3	3	$2,674.00	$2,005.50 25% off	$1,604.40	$2,005.50	$1,871.80	2026-01-01
L3906	HCPCS	Who Without Joints Cf	3	3	$1,198.00	$898.50 25% off	$718.80	$898.50	$838.60	2026-01-01
L3915	HCPCS	Who W Nontor Jnt(s) Prefab	3	3	$1,433.00	$1,074.75 25% off	$859.80	$1,074.75	$1,003.10	2026-01-01
L3961	HCPCS	Sewho Cap Design Without Jnts Cf	3	3	$1,428.46	$1,071.35 25% off	$857.08	$1,071.35	$999.92	2026-01-01
L3967	HCPCS	Sewho Airplane Without Jnts Cf	3	3	$1,686.53	$1,264.90 25% off	$1,011.92	$1,264.90	$1,180.57	2026-01-01
L3971	HCPCS	Sewho Cap Design W/jnt(s) Cf	3	3	$1,600.92	$1,200.69 25% off	$960.55	$1,200.69	$1,120.64	2026-01-01
L3973	HCPCS	Sewho Airplane W/jnt(s) Cf	3	3	$1,686.53	$1,264.90 25% off	$1,011.92	$1,264.90	$1,180.57	2026-01-01
L3975	HCPCS	Sewhfo Cap Design Without Jnt Cf	3	3	$1,428.46	$1,071.35 25% off	$857.08	$1,071.35	$999.92	2026-01-01
L3976	HCPCS	Sewhfo Airplane Without Jnts Cf	3	3	$1,428.46	$1,071.35 25% off	$857.08	$1,071.35	$999.92	2026-01-01
L3977	HCPCS	Sewhfo Cap Design W/jnts Cf	3	3	$1,600.92	$1,200.69 25% off	$960.55	$1,200.69	$1,120.64	2026-01-01
L3978	HCPCS	Sewhfo Airplane W/jnts Cf	3	3	$1,686.53	$1,264.90 25% off	$1,011.92	$1,264.90	$1,180.57	2026-01-01
L4000	HCPCS	Repl Girdle Milwaukee Orth	3	3	$1,232.03	$924.02 25% off	$739.22	$924.02	$862.42	2026-01-01
L4631	HCPCS	Afo, Walking Boot, Custom	3	3	$4,669.00	$3,501.75 25% off	$2,801.40	$3,501.75	$3,268.30	2026-01-01
L5000	HCPCS	Sho Insert W Arch Toe Filler	3	3	$1,648.00	$1,236.00 25% off	$988.80	$1,236.00	$1,153.60	2026-01-01
L5010	HCPCS	Mold Socket Ank Hgt W/toe F	3	3	$1,160.82	$870.62 25% off	$696.49	$870.62	$812.57	2026-01-01
L5020	HCPCS	Tibial Tubercle Hgt W/toe F	3	3	$1,889.57	$1,417.18 25% off	$1,133.74	$1,417.18	$1,322.70	2026-01-01
L5050	HCPCS	Ank Symes Mold Sckt Sach Ft	3	3	$2,188.21	$1,641.16 25% off	$1,312.93	$1,641.16	$1,531.75	2026-01-01
L5060	HCPCS	Symes Met Fr Leath Socket Ar	3	3	$2,633.54	$1,975.15 25% off	$1,580.12	$1,975.15	$1,843.48	2026-01-01
L5100	HCPCS	Molded Socket Shin Sach Foot	3	3	$2,279.54	$1,709.65 25% off	$1,367.72	$1,709.65	$1,595.68	2026-01-01
L5105	HCPCS	Plast Socket Jts/thgh Lacer	3	3	$3,618.10	$2,713.57 25% off	$2,170.86	$2,713.57	$2,532.67	2026-01-01
L5150	HCPCS	Mold Sckt Ext Knee Shin Sach	3	3	$3,348.35	$2,511.26 25% off	$2,009.01	$2,511.26	$2,343.84	2026-01-01
L5160	HCPCS	Mold Socket Bent Knee Shin S	3	3	$3,641.93	$2,731.45 25% off	$2,185.16	$2,731.45	$2,549.35	2026-01-01
L5200	HCPCS	Kne Sing Axis Fric Shin Sach	3	3	$3,172.43	$2,379.32 25% off	$1,903.46	$2,379.32	$2,220.70	2026-01-01
L5210	HCPCS	No Knee/ankle Joints W/ft B	3	3	$2,313.71	$1,735.28 25% off	$1,388.23	$1,735.28	$1,619.60	2026-01-01
L5220	HCPCS	No Knee Joint With Artic Ali	3	3	$2,629.96	$1,972.47 25% off	$1,577.98	$1,972.47	$1,840.97	2026-01-01
L5230	HCPCS	Fem Focal Defic Constant Fri	3	3	$3,627.23	$2,720.42 25% off	$2,176.34	$2,720.42	$2,539.06	2026-01-01
L5250	HCPCS	Hip Canad Sing Axi Cons Fric	3	3	$4,947.22	$3,710.41 25% off	$2,968.33	$3,710.41	$3,463.05	2026-01-01
L5270	HCPCS	Tilt Table Locking Hip Sing	3	3	$4,903.87	$3,677.90 25% off	$2,942.32	$3,677.90	$3,432.71	2026-01-01
L5280	HCPCS	Hemipelvect Canad Sing Axis	3	3	$4,854.84	$3,641.13 25% off	$2,912.90	$3,641.13	$3,398.39	2026-01-01
L5301	HCPCS	Bk Mold Socket Sach Ft Endo	3	3	$2,189.23	$1,641.92 25% off	$1,313.54	$1,641.92	$1,532.46	2026-01-01
L5321	HCPCS	Ak Open End Sach	3	3	$3,133.83	$2,350.37 25% off	$1,880.30	$2,350.37	$2,193.68	2026-01-01
L5331	HCPCS	Hip Disart Canadian Sach Ft	3	3	$4,434.48	$3,325.86 25% off	$2,660.69	$3,325.86	$3,104.14	2026-01-01
L5341	HCPCS	Hemipelvectomy Canadian Sach	3	3	$4,818.88	$3,614.16 25% off	$2,891.33	$3,614.16	$3,373.22	2026-01-01
L5400	HCPCS	Postop Dress & 1 Cast Chg Bk	3	3	$1,147.56	$860.67 25% off	$688.54	$860.67	$803.29	2026-01-01
L5420	HCPCS	Postop Dsg & 1 Cast Chg Ak/d	3	3	$1,449.32	$1,086.99 25% off	$869.59	$1,086.99	$1,014.52	2026-01-01
L5460	HCPCS	Postop App Non-wgt Bear Dsg	3	3	$1,753.00	$1,314.75 25% off	$1,051.80	$1,314.75	$1,227.10	2026-01-01
L5500	HCPCS	Init Bk Ptb Plaster Direct	3	3	$1,224.59	$918.44 25% off	$734.75	$918.44	$857.21	2026-01-01
L5505	HCPCS	Init Ak Ischal Plstr Direct	3	3	$1,658.41	$1,243.81 25% off	$995.05	$1,243.81	$1,160.89	2026-01-01
L5510	HCPCS	Prep Bk Ptb Plaster Molded	3	3	$1,388.16	$1,041.12 25% off	$832.90	$1,041.12	$971.71	2026-01-01
L5520	HCPCS	Perp Bk Ptb Thermopls Direct	3	3	$1,371.16	$1,028.37 25% off	$822.70	$1,028.37	$959.81	2026-01-01
L5530	HCPCS	Prep Bk Ptb Thermopls Molded	3	3	$1,735.61	$1,301.71 25% off	$1,041.37	$1,301.71	$1,214.93	2026-01-01
L5535	HCPCS	Prep Bk Ptb Open End Socket	3	3	$1,710.43	$1,282.82 25% off	$1,026.26	$1,282.82	$1,197.30	2026-01-01
L5540	HCPCS	Prep Bk Ptb Laminated Socket	3	3	$1,806.14	$1,354.61 25% off	$1,083.68	$1,354.61	$1,264.30	2026-01-01
L5560	HCPCS	Prep Ak Ischial Plast Molded	3	3	$1,853.18	$1,389.88 25% off	$1,111.91	$1,389.88	$1,297.23	2026-01-01
L5570	HCPCS	Prep Ak Ischial Direct Form	3	3	$1,926.65	$1,444.99 25% off	$1,155.99	$1,444.99	$1,348.65	2026-01-01
L5580	HCPCS	Prep Ak Ischial Thermo Mold	3	3	$2,249.23	$1,686.92 25% off	$1,349.54	$1,686.92	$1,574.46	2026-01-01
L5585	HCPCS	Prep Ak Ischial Open End	3	3	$2,439.56	$1,829.67 25% off	$1,463.74	$1,829.67	$1,707.69	2026-01-01
L5590	HCPCS	Prep Ak Ischial Laminated	3	3	$2,292.12	$1,719.09 25% off	$1,375.27	$1,719.09	$1,604.48	2026-01-01
L5595	HCPCS	Hip Disartic Sach Thermopls	3	3	$4,028.94	$3,021.70 25% off	$2,417.36	$3,021.70	$2,820.26	2026-01-01
L5600	HCPCS	Hip Disart Sach Laminat Mold	3	3	$4,394.45	$3,295.84 25% off	$2,636.67	$3,295.84	$3,076.11	2026-01-01
L5610	HCPCS	Above Knee Hydracadence	3	3	$1,974.09	$1,480.57 25% off	$1,184.45	$1,480.57	$1,381.86	2026-01-01
L5611	HCPCS	Ak 4 Bar Link W/fric Swing	3	3	$1,536.23	$1,152.17 25% off	$921.74	$1,152.17	$1,075.36	2026-01-01
L5613	HCPCS	Ak 4 Bar Ling W/hydraul Swig	3	3	$2,336.71	$1,752.53 25% off	$1,402.03	$1,752.53	$1,635.70	2026-01-01
L5614	HCPCS	4-bar Link Above Knee W/swing	3	3	$1,579.52	$1,184.64 25% off	$947.71	$1,184.64	$1,105.66	2026-01-01
L5616	HCPCS	Ak Univ Multiplex Sys Frict	3	3	$1,294.99	$971.24 25% off	$776.99	$971.24	$906.49	2026-01-01
L5624	HCPCS	Test Socket Above Knee	3	3	$1,220.00	$915.00 25% off	$732.00	$915.00	$854.00	2026-01-01
L5631	HCPCS	Ak/knee Disartic Acrylic Soc	3	3	$1,467.00	$1,100.25 25% off	$880.20	$1,100.25	$1,026.90	2026-01-01
L5639	HCPCS	Below Knee Wood Socket	3	3	$1,088.57	$816.43 25% off	$653.14	$816.43	$762.00	2026-01-01
L5643	HCPCS	Hip Flex Inner Socket Ext Fr	3	3	$1,484.04	$1,113.03 25% off	$890.42	$1,113.03	$1,038.83	2026-01-01
L5649	HCPCS	Isch Containmt/narrow M-i So	3	3	$6,317.00	$4,737.75 25% off	$3,790.20	$4,737.75	$4,421.90	2026-01-01
L5650	HCPCS	Tot Contact Ak/knee Disart S	3	3	$1,652.00	$1,239.00 25% off	$991.20	$1,239.00	$1,156.40	2026-01-01
L5651	HCPCS	Ak Flex Inner Sicket Ext Fra	3	3	$4,003.00	$3,002.25 25% off	$2,401.80	$3,002.25	$2,802.10	2026-01-01
L5673	HCPCS	Socket Insert W Lock Mech	3	3	$2,212.00	$1,659.00 25% off	$1,327.20	$1,659.00	$1,548.40	2026-01-01
L5679	HCPCS	Socket Insert Without Lock Mech	3	3	$1,844.00	$1,383.00 25% off	$1,106.40	$1,383.00	$1,290.80	2026-01-01
L5681	HCPCS	Intl Custm Cong/latyp Insert	3	3	$1,231.25	$923.44 25% off	$738.75	$923.44	$861.88	2026-01-01
L5683	HCPCS	Initial Custom Socket Insert	3	3	$1,231.25	$923.44 25% off	$738.75	$923.44	$861.88	2026-01-01
L5700	HCPCS	Replace Socket Below Knee	3	3	$2,746.92	$2,060.19 25% off	$1,648.15	$2,060.19	$1,922.84	2026-01-01
L5701	HCPCS	Replace Socket Above Knee	3	3	$7,445.00	$5,583.75 25% off	$4,467.00	$5,583.75	$5,211.50	2026-01-01
L5702	HCPCS	Replace Socket Hip	3	3	$4,295.03	$3,221.27 25% off	$2,577.02	$3,221.27	$3,006.52	2026-01-01
L5703	HCPCS	Symes Ankle Without (sach) Foot	3	3	$1,994.57	$1,495.93 25% off	$1,196.74	$1,495.93	$1,396.20	2026-01-01
L5707	HCPCS	Custom Shape Cvr Hip Disart	3	3	$1,345.59	$1,009.19 25% off	$807.35	$1,009.19	$941.91	2026-01-01
L5724	HCPCS	Knee-shin Exo Fluid Swing Ph	3	3	$1,439.21	$1,079.41 25% off	$863.53	$1,079.41	$1,007.45	2026-01-01
L5726	HCPCS	Knee-shin Ext Jnts Fld Swg E	3	3	$1,889.83	$1,417.37 25% off	$1,133.90	$1,417.37	$1,322.88	2026-01-01
L5728	HCPCS	Knee-shin Fluid Swg & Stance	3	3	$2,354.48	$1,765.86 25% off	$1,412.69	$1,765.86	$1,648.14	2026-01-01
L5780	HCPCS	Knee-shin Pneum/hydra Pneum	3	3	$1,135.22	$851.41 25% off	$681.13	$851.41	$794.65	2026-01-01
L5781	HCPCS	Lower Limb Pros Vacuum Pump	3	3	$3,745.23	$2,808.92 25% off	$2,247.14	$2,808.92	$2,621.66	2026-01-01
L5782	HCPCS	Hd Low Limb Pros Vacuum Pump	3	3	$3,948.32	$2,961.24 25% off	$2,368.99	$2,961.24	$2,763.82	2026-01-01
L5814	HCPCS	Endo Knee-shin Hydral Swg Ph	3	3	$3,476.30	$2,607.22 25% off	$2,085.78	$2,607.22	$2,433.41	2026-01-01
L5822	HCPCS	Endo Knee-shin Pneum Swg Frc	3	3	$1,776.45	$1,332.34 25% off	$1,065.87	$1,332.34	$1,243.52	2026-01-01
L5824	HCPCS	Endo Knee-shin Fluid Swing P	3	3	$1,462.23	$1,096.67 25% off	$877.34	$1,096.67	$1,023.56	2026-01-01
L5826	HCPCS	Miniature Knee Joint	3	3	$2,952.39	$2,214.29 25% off	$1,771.43	$2,214.29	$2,066.67	2026-01-01
L5828	HCPCS	Endo Knee-shin Fluid Swg/sta	3	3	$2,787.33	$2,090.50 25% off	$1,672.40	$2,090.50	$1,951.13	2026-01-01
L5830	HCPCS	Endo Knee-shin Pneum/swg Pha	3	3	$1,980.51	$1,485.38 25% off	$1,188.31	$1,485.38	$1,386.36	2026-01-01
L5840	HCPCS	Multi-axial Knee/shin System	3	3	$3,492.40	$2,619.30 25% off	$2,095.44	$2,619.30	$2,444.68	2026-01-01
L5845	HCPCS	Knee-shin Sys Stance Flexion	3	3	$1,677.72	$1,258.29 25% off	$1,006.63	$1,258.29	$1,174.40	2026-01-01
L5856	HCPCS	Elec Knee-shin Swing/stance	3	3	$22,470.36	$16,852.77 25% off	$13,482.22	$16,852.77	$15,729.25	2026-01-01
L5857	HCPCS	Elec Knee-shin Swing Only	3	3	$7,973.35	$5,980.01 25% off	$4,784.01	$5,980.01	$5,581.35	2026-01-01
L5858	HCPCS	Stance Phase Only	3	3	$17,396.43	$13,047.32 25% off	$10,437.86	$13,047.32	$12,177.50	2026-01-01
L5859	HCPCS	Knee-shin Pro Flex/ext Cont	3	3	$13,581.25	$10,185.94 25% off	$8,148.75	$10,185.94	$9,506.88	2026-01-01
L5930	HCPCS	High Activity Kinee Frame	3	3	$3,150.62	$2,362.97 25% off	$1,890.37	$2,362.97	$2,205.43	2026-01-01
L5950	HCPCS	Endo Ak Ultra-light Material	3	3	$2,549.00	$1,911.75 25% off	$1,529.40	$1,911.75	$1,784.30	2026-01-01
L5961	HCPCS	Endo Poly Hip, Pneu/hyd/rot	3	3	$4,337.85	$3,253.39 25% off	$2,602.71	$3,253.39	$3,036.49	2026-01-01
L5966	HCPCS	Hip Flexible Cover System	3	3	$1,293.16	$969.87 25% off	$775.90	$969.87	$905.21	2026-01-01
L5968	HCPCS	Multiaxial Ankle W Dorsiflex	3	3	$3,401.48	$2,551.11 25% off	$2,040.89	$2,551.11	$2,381.04	2026-01-01
L5973	HCPCS	Ank-foot Sys Dors-plant Flex	3	3	$16,387.48	$12,290.61 25% off	$9,832.49	$12,290.61	$11,471.24	2026-01-01
L5979	HCPCS	Multi-axial Ankle/ft Prosth	3	3	$2,232.81	$1,674.61 25% off	$1,339.69	$1,674.61	$1,562.97	2026-01-01
L5980	HCPCS	Flex Foot System	3	3	$3,535.25	$2,651.44 25% off	$2,121.15	$2,651.44	$2,474.68	2026-01-01
L5981	HCPCS	Flex-walk Sys Low Ext Prosth	3	3	$3,055.76	$2,291.82 25% off	$1,833.46	$2,291.82	$2,139.03	2026-01-01
L5987	HCPCS	Shank Ft W Vert Load Pylon	3	3	$6,733.58	$5,050.19 25% off	$4,040.15	$5,050.19	$4,713.51	2026-01-01
L5988	HCPCS	Vertical Shock Reducing Pylo	3	3	$1,869.93	$1,402.45 25% off	$1,121.96	$1,402.45	$1,308.95	2026-01-01
L5990	HCPCS	User Adjustable Heel Height	3	3	$1,698.18	$1,273.63 25% off	$1,018.91	$1,273.63	$1,188.73	2026-01-01
L6000	HCPCS	Par Hand Robin-aids Thum Rem	3	3	$1,266.89	$950.17 25% off	$760.13	$950.17	$886.82	2026-01-01
L6010	HCPCS	Hand Robin-aids Little/ring	3	3	$1,409.84	$1,057.38 25% off	$845.90	$1,057.38	$986.89	2026-01-01
L6020	HCPCS	Part Hand Robin-aids No Fing	3	3	$1,314.45	$985.84 25% off	$788.67	$985.84	$920.12	2026-01-01
L6050	HCPCS	Wrst Mld Sck Flx Hng Tri Pad	3	3	$1,811.26	$1,358.44 25% off	$1,086.76	$1,358.44	$1,267.88	2026-01-01
L6055	HCPCS	Wrst Mold Sock W/exp Interfa	3	3	$2,879.08	$2,159.31 25% off	$1,727.45	$2,159.31	$2,015.36	2026-01-01
L6100	HCPCS	Elb Mold Sock Flex Hinge Pad	3	3	$1,835.09	$1,376.32 25% off	$1,101.05	$1,376.32	$1,284.56	2026-01-01
L6110	HCPCS	Elbow Mold Sock Suspension T	3	3	$1,946.42	$1,459.82 25% off	$1,167.85	$1,459.82	$1,362.49	2026-01-01
L6120	HCPCS	Elbow Mold Doub Splt Soc Ste	3	3	$2,268.28	$1,701.21 25% off	$1,360.97	$1,701.21	$1,587.80	2026-01-01
L6130	HCPCS	Elbow Stump Activated Lock H	3	3	$2,468.31	$1,851.23 25% off	$1,480.99	$1,851.23	$1,727.82	2026-01-01
L6200	HCPCS	Elbow Mold Outsid Lock Hinge	3	3	$2,604.19	$1,953.14 25% off	$1,562.51	$1,953.14	$1,822.93	2026-01-01
L6205	HCPCS	Elbow Molded W/expand Inter	3	3	$4,334.61	$3,250.96 25% off	$2,600.77	$3,250.96	$3,034.23	2026-01-01
L6250	HCPCS	Elbow Inter Loc Elbow Forarm	3	3	$2,560.44	$1,920.33 25% off	$1,536.26	$1,920.33	$1,792.31	2026-01-01
L6300	HCPCS	Shlder Disart Int Lock Elbow	3	3	$3,552.34	$2,664.26 25% off	$2,131.40	$2,664.26	$2,486.64	2026-01-01
L6310	HCPCS	Shoulder Passive Restor Comp	3	3	$2,921.34	$2,191.01 25% off	$1,752.80	$2,191.01	$2,044.94	2026-01-01
L6320	HCPCS	Shoulder Passive Restor Cap	3	3	$1,629.44	$1,222.08 25% off	$977.66	$1,222.08	$1,140.61	2026-01-01
L6350	HCPCS	Thoracic Intern Lock Elbow	3	3	$3,734.74	$2,801.05 25% off	$2,240.84	$2,801.05	$2,614.32	2026-01-01
L6360	HCPCS	Thoracic Passive Restor Comp	3	3	$3,066.00	$2,299.50 25% off	$1,839.60	$2,299.50	$2,146.20	2026-01-01
L6370	HCPCS	Thoracic Passive Restor Cap	3	3	$2,308.22	$1,731.16 25% off	$1,384.93	$1,731.16	$1,615.75	2026-01-01
L6380	HCPCS	Postop Dsg Cast Chg Wrst/elb	3	3	$1,246.65	$934.99 25% off	$747.99	$934.99	$872.65	2026-01-01
L6382	HCPCS	Postop Dsg Cast Chg Elb Dis/	3	3	$1,491.79	$1,118.84 25% off	$895.07	$1,118.84	$1,044.25	2026-01-01
L6384	HCPCS	Postop Dsg Cast Chg Shlder/t	3	3	$1,820.39	$1,365.29 25% off	$1,092.23	$1,365.29	$1,274.27	2026-01-01
L6400	HCPCS	Below Elbow Prosth Tiss Shap	3	3	$2,217.13	$1,662.85 25% off	$1,330.28	$1,662.85	$1,551.99	2026-01-01
L6450	HCPCS	Elb Disart Prosth Tiss Shap	3	3	$2,939.68	$2,204.76 25% off	$1,763.81	$2,204.76	$2,057.78	2026-01-01
L6500	HCPCS	Above Elbow Prosth Tiss Shap	3	3	$2,942.09	$2,206.57 25% off	$1,765.25	$2,206.57	$2,059.46	2026-01-01
L6550	HCPCS	Shldr Disar Prosth Tiss Shap	3	3	$3,635.88	$2,726.91 25% off	$2,181.53	$2,726.91	$2,545.12	2026-01-01
L6570	HCPCS	Scap Thorac Prosth Tiss Shap	3	3	$4,411.57	$3,308.68 25% off	$2,646.94	$3,308.68	$3,088.10	2026-01-01
L6580	HCPCS	Wrist/elbow Bowden Cable Mol	3	3	$1,539.92	$1,154.94 25% off	$923.95	$1,154.94	$1,077.94	2026-01-01
L6582	HCPCS	Wrist/elbow Bowden Cbl Dir F	3	3	$1,312.29	$984.22 25% off	$787.37	$984.22	$918.60	2026-01-01
L6584	HCPCS	Elbow Fair Lead Cable Molded	3	3	$2,125.68	$1,594.26 25% off	$1,275.41	$1,594.26	$1,487.98	2026-01-01
L6586	HCPCS	Elbow Fair Lead Cable Dir Fo	3	3	$1,859.53	$1,394.65 25% off	$1,115.72	$1,394.65	$1,301.67	2026-01-01
L6588	HCPCS	Shdr Fair Lead Cable Molded	3	3	$3,069.65	$2,302.24 25% off	$1,841.79	$2,302.24	$2,148.76	2026-01-01
L6590	HCPCS	Shdr Fair Lead Cable Direct	3	3	$2,807.87	$2,105.90 25% off	$1,684.72	$2,105.90	$1,965.51	2026-01-01
L6621	HCPCS	Flex/ext Wrist W/wo Friction	3	3	$2,141.00	$1,605.75 25% off	$1,284.60	$1,605.75	$1,498.70	2026-01-01
L6624	HCPCS	Flex/ext/rotation Wrist Unit	3	3	$3,525.22	$2,643.91 25% off	$2,115.13	$2,643.91	$2,467.65	2026-01-01
L6638	HCPCS	Elec Lock On Manual Pw Elbow	3	3	$2,340.78	$1,755.59 25% off	$1,404.47	$1,755.59	$1,638.55	2026-01-01
L6646	HCPCS	Multipo Locking Shoulder Jnt	3	3	$2,952.26	$2,214.20 25% off	$1,771.36	$2,214.20	$2,066.58	2026-01-01
L6648	HCPCS	Ext Pwrd Shlder Lock/unlock	3	3	$3,044.83	$2,283.62 25% off	$1,826.90	$2,283.62	$2,131.38	2026-01-01
L6693	HCPCS	Lockingelbow Forearm Cntrbal	3	3	$2,657.41	$1,993.06 25% off	$1,594.45	$1,993.06	$1,860.19	2026-01-01
L6696	HCPCS	Cus Elbo Skt In For Con/atyp	3	3	$1,231.25	$923.44 25% off	$738.75	$923.44	$861.88	2026-01-01
L6697	HCPCS	Cus Elbo Skt In Not Con/atyp	3	3	$1,231.25	$923.44 25% off	$738.75	$923.44	$861.88	2026-01-01
L6707	HCPCS	Term Dev Mech Hook Col Close	3	3	$1,402.15	$1,051.61 25% off	$841.29	$1,051.61	$981.50	2026-01-01
L6709	HCPCS	Term Dev Mech Hand Col Close	3	3	$1,290.81	$968.11 25% off	$774.49	$968.11	$903.57	2026-01-01
L6712	HCPCS	Ped Term Dev, Hook, Vol Clos	3	3	$1,158.67	$869.00 25% off	$695.20	$869.00	$811.07	2026-01-01
L6713	HCPCS	Ped Term Dev, Hand, Vol Open	3	3	$1,462.39	$1,096.79 25% off	$877.43	$1,096.79	$1,023.67	2026-01-01
L6714	HCPCS	Ped Term Dev, Hand, Vol Clos	3	3	$1,238.61	$928.96 25% off	$743.17	$928.96	$867.03	2026-01-01
L6721	HCPCS	Hook/hand, Hvy Dty, Vol Open	3	3	$2,201.52	$1,651.14 25% off	$1,320.91	$1,651.14	$1,541.06	2026-01-01
L6722	HCPCS	Hook/hand, Hvy Dty, Vol Clos	3	3	$1,897.88	$1,423.41 25% off	$1,138.73	$1,423.41	$1,328.52	2026-01-01
L6881	HCPCS	Term Dev Auto Grasp Feature	3	3	$3,826.75	$2,870.06 25% off	$2,296.05	$2,870.06	$2,678.72	2026-01-01
L6882	HCPCS	Microprocessor Control Uplmb	3	3	$2,902.76	$2,177.07 25% off	$1,741.66	$2,177.07	$2,031.93	2026-01-01
L6883	HCPCS	Replc Sockt Below E/w Disa	3	3	$1,513.07	$1,134.80 25% off	$907.84	$1,134.80	$1,059.15	2026-01-01
L6884	HCPCS	Replc Sockt Above Elbow Disa	3	3	$2,128.67	$1,596.50 25% off	$1,277.20	$1,596.50	$1,490.07	2026-01-01
L6885	HCPCS	Replc Sockt Shldr Dis/interc	3	3	$3,066.00	$2,299.50 25% off	$1,839.60	$2,299.50	$2,146.20	2026-01-01
L6900	HCPCS	Hand Restorat Thumb/1 Finger	3	3	$1,531.91	$1,148.93 25% off	$919.15	$1,148.93	$1,072.34	2026-01-01
L6905	HCPCS	Hand Restoration Multiple Fi	3	3	$1,503.91	$1,127.93 25% off	$902.35	$1,127.93	$1,052.74	2026-01-01
L6910	HCPCS	Hand Restoration No Fingers	3	3	$1,543.87	$1,157.90 25% off	$926.32	$1,157.90	$1,080.71	2026-01-01
L6920	HCPCS	Wrist Disarticul Switch Ctrl	3	3	$7,349.70	$5,512.27 25% off	$4,409.82	$5,512.27	$5,144.79	2026-01-01
L6925	HCPCS	Wrist Disart Myoelectronic C	3	3	$8,057.40	$6,043.05 25% off	$4,834.44	$6,043.05	$5,640.18	2026-01-01
L6930	HCPCS	Below Elbow Switch Control	3	3	$6,952.99	$5,214.74 25% off	$4,171.79	$5,214.74	$4,867.09	2026-01-01
L6935	HCPCS	Below Elbow Myoelectronic CT	3	3	$8,227.67	$6,170.75 25% off	$4,936.60	$6,170.75	$5,759.37	2026-01-01
L6940	HCPCS	Elbow Disarticulation Switch	3	3	$9,064.49	$6,798.37 25% off	$5,438.69	$6,798.37	$6,345.14	2026-01-01
L6945	HCPCS	Elbow Disart Myoelectronic C	3	3	$10,138.46	$7,603.85 25% off	$6,083.08	$7,603.85	$7,096.92	2026-01-01
L6950	HCPCS	Above Elbow Switch Control	3	3	$9,606.43	$7,204.82 25% off	$5,763.86	$7,204.82	$6,724.50	2026-01-01
L6955	HCPCS	Above Elbow Myoelectronic CT	3	3	$11,683.27	$8,762.45 25% off	$7,009.96	$8,762.45	$8,178.29	2026-01-01
L6960	HCPCS	Shldr Disartic Switch Contro	3	3	$12,403.58	$9,302.68 25% off	$7,442.15	$9,302.68	$8,682.51	2026-01-01
L6965	HCPCS	Shldr Disartic Myoelectronic	3	3	$14,208.25	$10,656.19 25% off	$8,524.95	$10,656.19	$9,945.77	2026-01-01
L6970	HCPCS	Interscapular-thor Switch CT	3	3	$15,271.03	$11,453.27 25% off	$9,162.62	$11,453.27	$10,689.72	2026-01-01
L6975	HCPCS	Interscap-thor Myoelectronic	3	3	$16,859.43	$12,644.57 25% off	$10,115.66	$12,644.57	$11,801.60	2026-01-01
L7007	HCPCS	Adult Electric Hand	3	3	$3,458.32	$2,593.74 25% off	$2,074.99	$2,593.74	$2,420.82	2026-01-01
L7008	HCPCS	Pediatric Electric Hand	3	3	$5,842.38	$4,381.78 25% off	$3,505.43	$4,381.78	$4,089.67	2026-01-01
L7009	HCPCS	Adult Electric Hook	3	3	$3,536.54	$2,652.41 25% off	$2,121.92	$2,652.41	$2,475.58	2026-01-01
L7040	HCPCS	Prehensile Actuator	3	3	$2,773.73	$2,080.30 25% off	$1,664.24	$2,080.30	$1,941.61	2026-01-01
L7045	HCPCS	Pediatric Electric Hook	3	3	$1,541.15	$1,155.86 25% off	$924.69	$1,155.86	$1,078.81	2026-01-01
L7170	HCPCS	Electronic Elbow Hosmer Swit	3	3	$5,590.78	$4,193.09 25% off	$3,354.47	$4,193.09	$3,913.55	2026-01-01
L7180	HCPCS	Electronic Elbow Sequential	3	3	$33,291.60	$24,968.70 25% off	$19,974.96	$24,968.70	$23,304.12	2026-01-01
L7181	HCPCS	Electronic Elbo Simultaneous	3	3	$37,505.21	$28,128.91 25% off	$22,503.13	$28,128.91	$26,253.65	2026-01-01
L7185	HCPCS	Electron Elbow Adolescent Sw	3	3	$5,724.03	$4,293.02 25% off	$3,434.42	$4,293.02	$4,006.82	2026-01-01
L7186	HCPCS	Electron Elbow Child Switch	3	3	$8,741.06	$6,555.80 25% off	$5,244.64	$6,555.80	$6,118.74	2026-01-01
L7190	HCPCS	Elbow Adolescent Myoelectron	3	3	$7,452.46	$5,589.35 25% off	$4,471.48	$5,589.35	$5,216.72	2026-01-01
L7191	HCPCS	Elbow Child Myoelectronic CT	3	3	$9,414.85	$7,061.14 25% off	$5,648.91	$7,061.14	$6,590.40	2026-01-01
L8035	HCPCS	Custom Breast Prosthesis	3	3	$3,429.30	$2,571.97 25% off	$2,057.58	$2,571.97	$2,400.51	2026-01-01
L8040	HCPCS	Nasal Prosthesis	3	3	$2,385.78	$1,789.34 25% off	$1,431.47	$1,789.34	$1,670.05	2026-01-01
L8041	HCPCS	Midfacial Prosthesis	3	3	$2,875.65	$2,156.74 25% off	$1,725.39	$2,156.74	$2,012.95	2026-01-01
L8042	HCPCS	Orbital Prosthesis	3	3	$3,231.06	$2,423.30 25% off	$1,938.64	$2,423.30	$2,261.74	2026-01-01
L8043	HCPCS	Upper Facial Prosthesis	3	3	$3,618.84	$2,714.13 25% off	$2,171.30	$2,714.13	$2,533.19	2026-01-01
L8044	HCPCS	Hemi-facial Prosthesis	3	3	$4,006.53	$3,004.90 25% off	$2,403.92	$3,004.90	$2,804.57	2026-01-01
L8045	HCPCS	Auricular Prosthesis	3	3	$2,796.88	$2,097.66 25% off	$1,678.13	$2,097.66	$1,957.82	2026-01-01
L8046	HCPCS	Partial Facial Prosthesis	3	3	$2,584.85	$1,938.64 25% off	$1,550.91	$1,938.64	$1,809.39	2026-01-01
L8609	HCPCS	Artificial Cornea	3	3	$6,098.69	$4,574.02 25% off	$3,659.21	$4,574.02	$4,269.08	2026-01-01
L8614	HCPCS	Cochlear Device	3	3	$18,592.92	$13,944.69 25% off	$11,155.75	$13,944.69	$13,015.04	2026-01-01
L8619	HCPCS	Replace Cochlear Processor	3	3	$7,981.81	$5,986.36 25% off	$4,789.09	$5,986.36	$5,587.27	2026-01-01
L8627	HCPCS	Cid Ext Speech Process Repl	3	3	$6,819.04	$5,114.28 25% off	$4,091.42	$5,114.28	$4,773.33	2026-01-01
L8628	HCPCS	Cid Ext Controller Repl	3	3	$1,162.75	$872.06 25% off	$697.65	$872.06	$813.92	2026-01-01
L8631	HCPCS	Mcp Joint Repl 2 Pc Or More	3	3	$2,032.05	$1,524.04 25% off	$1,219.23	$1,524.04	$1,422.43	2026-01-01
L8659	HCPCS	Interphalangeal Joint Repl	3	3	$1,806.26	$1,354.69 25% off	$1,083.76	$1,354.69	$1,264.38	2026-01-01
L8682	HCPCS	Implt Neurostim Radiofq Rec	3	3	$5,603.54	$4,202.65 25% off	$3,362.12	$4,202.65	$3,922.48	2026-01-01
L8683	HCPCS	Radiofq Trsmtr For Implt Neu	3	3	$4,932.39	$3,699.29 25% off	$2,959.43	$3,699.29	$3,452.67	2026-01-01
L8689	HCPCS	External Recharg Sys Intern	3	3	$1,614.61	$1,210.96 25% off	$968.77	$1,210.96	$1,130.23	2026-01-01
L8690	HCPCS	Aud Osseo Dev, Int/ext Comp	3	3	$4,452.90	$3,339.68 25% off	$2,671.74	$3,339.68	$3,117.03	2026-01-01
L8691	HCPCS	Aud Osseo Dev Ext Snd Process	3	3	$2,495.99	$1,871.99 25% off	$1,497.59	$1,871.99	$1,747.19	2026-01-01
L8693	HCPCS	Aud Osseo Dev, Abutment	3	3	$1,419.34	$1,064.51 25% off	$851.60	$1,064.51	$993.54	2026-01-01
P9037	HCPCS	Platelets Irradiated 1 Unit	3	3	$1,852.00	$1,389.00 25% off	$1,111.20	$1,389.00	$1,296.40	2026-01-01

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