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Wisconsin rates for HCPCS L2628

Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables

Facilitymedian $1,905 · 10th–90th $1,549$3,4670%20%40%10th90th$1,905Professionalmedian $1,413 · 10th–90th $891$2,8840%20%10th90th$1,413$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$954.99 / $954.99 / $954.99
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $977.24 / $1,819.70
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $3,162.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $2,137.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $4,466.84 / $9,549.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $2,754.23 / $3,630.78
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $1,548.82 / $2,398.83
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,905.46 / $2,290.87
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $1,905.46 / $10,000.00
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,096.48 / $2,137.96
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $1,258.93
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,019.95 / $3,019.95
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $2,187.76 / $3,801.89
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,951.21 / $5,888.44
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $3,801.89 / $10,000.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,737.80 / $12,589.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $1,071.52 / $1,905.46
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $933.25 / $1,659.59