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Pennsylvania rates for HCPCS L2622

Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each

Facilitymedian $398 · 10th–90th $158–$6170%20%10th90th$398Professionalmedian $195 · 10th–90th $151–$3090%20%40%10th90th$195$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$158.49 / $616.60 / $616.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $194.98 / $275.42
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
$389.05 / $389.05 / $389.05
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $346.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $213.80
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $457.09 / $676.08
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $398.11
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $257.04 / $398.11
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $158.49
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $194.98 / $263.03
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $467.74 / $676.08
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $407.38
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $371.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $467.74 / $537.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $194.98 / $354.81