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Washington rates for HCPCS L2650

Addition to lower extremity, pelvic and thoracic control, gluteal pad, each

Facilitymedian $178 · 10th–90th $107–$3550%20%10th90th$178Professionalmedian $117 · 10th–90th $62–$2240%10%10th90th$117$1.0$5.0$20.0$100.0$500.0

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
$120.23 / $120.23 / $288.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $81.28 / $158.49
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $177.83 / $177.83
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $204.17
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $112.20
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $199.53 / $512.86
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $194.98 / $316.23
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $138.04 / $151.36
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $177.83 / $181.97
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $144.54 / $181.97
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $263.03 / $363.08
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $177.83
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $154.88 / $204.17
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $181.97 / $218.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $72.44 / $128.82
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $154.88 / $275.42