Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials
Jourdanton, TX
See all hospitals reporting HCPCS L5657 →Price type
Methodist Hospital Atascosa’s median price of $306 is about the same as the median hospital's median price ($309), higher than 13% of the 120 hospitals reporting HCPCS L5657. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 23 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield mybluehealth fee schedule · outpatient | $82 | $82 | — | — | — | $82 – $82 |
| 2 | Blue Cross Blue Shield blueadvantage fee schedule · outpatient | $94 | $94 | — | — | — | $94 – $94 |
| 3 | Blue Cross Blue Shield blueessentials fee schedule · outpatient | $121 | $121 | — | — | — | $121 – $121 |
| 4 | Blue Cross Blue Shield blueessentialsaccess fee schedule · outpatient | $121 | $121 | — | — | — | $121 – $121 |
| 5 | Blue Cross Blue Shield healthselectopenaccess(eposoa) fee schedule · outpatient | $133 | $133 | — | — | — | $133 – $133 |
| 6 | Blue Cross Blue Shield ppo fee schedule · outpatient | $144 | $144 | — | — | — | $144 – $144 |
| 7 | Blue Cross Blue Shield mgmcrhmo fee schedule · outpatient | $306 | $306 | — | — | — | $306 – $306 |
| 8 | Blue Cross Blue Shield mgmcrpos fee schedule · outpatient | $306 | $306 | — | — | — | $306 – $306 |
| 9 | Blue Cross Blue Shield mgmcrppo fee schedule · outpatient | $306 | $306 | — | — | — | $306 – $306 |
| 10 | Devoted dualeligible fee schedule · outpatient | $306 | $306 | — | — | — | $306 – $306 |
| 11 | Devoted mcrhmo fee schedule · outpatient | $306 | $306 | — | — | — | $306 – $306 |
| 12 | Devoted mcrpffs fee schedule · outpatient | $306 | $306 | — | — | — | $306 – $306 |
| 13 | Devoted mcrpos fee schedule · outpatient | $306 | $306 | — | — | — | $306 – $306 |
| 14 | Devoted mcrppo fee schedule · outpatient | $306 | $306 | — | — | — | $306 – $306 |
| 15 | Devoted mcrsnp fee schedule · outpatient | $306 | $306 | — | — | — | $306 – $306 |
| 16 | Aetna mcr fee schedule · outpatient | $312 | $312 | — | — | — | $312 – $312 |
| 17 | UnitedHealthcare mcr fee schedule · outpatient | $312 | $312 | — | — | — | $312 – $312 |
| 18 | WellCare mcrhmo fee schedule · outpatient | $316 | $316 | — | — | — | $316 – $316 |
| 19 | WellCare mcrpos fee schedule · outpatient | $316 | $316 | — | — | — | $316 – $316 |
| 20 | WellCare mcrppo fee schedule · outpatient | $316 | $316 | — | — | — | $316 – $316 |
| 21 | WellCare mcrsnp fee schedule · outpatient | $316 | $316 | — | — | — | $316 – $316 |
| 22 | WellCare pffs fee schedule · outpatient | $316 | $316 | — | — | — | $316 – $316 |
| 23 | Clover mcr fee schedule · outpatient | $322 | $322 | — | — | — | $322 – $322 |
Last updated: May 1, 2026
See Prosthetic leg socket insert for adjusting limb volume pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.