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Washington rates for HCPCS L2622

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

Facilitymedian $347 · 10th–90th $234–$8510%20%10th90th$347Professionalmedian $234 · 10th–90th $170–$5500%20%10th90th$234$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
$234.42 / $234.42 / $549.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $208.93 / $302.00
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $338.84 / $338.84
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $389.05
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $213.80
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $489.78 / $977.24
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $436.52 / $794.33
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $263.03 / $288.40
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $338.84 / $346.74
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $346.74 / $346.74
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $501.19 / $691.83
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $338.84
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $389.05
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $467.74 / $562.34
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $199.53 / $331.13
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $302.00 / $524.81