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Washington rates for HCPCS L5105

Below knee (BK), plastic socket, joints and thigh lacer, SACH foot

Facilitymedian $4,786 · 10th–90th $3,090–$10,9650%20%10th90th$4,786Professionalmedian $3,162 · 10th–90th $1,950–$6,7610%10%20%10th90th$3,162$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$3,090.30 / $3,090.30 / $7,244.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,511.89 / $3,981.07
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,570.88 / $4,570.88
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,073.80 / $5,370.32
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,019.95 / $3,019.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $3,019.95
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $6,165.95 / $13,489.63
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $5,495.41 / $9,549.93
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $3,630.78 / $3,981.07
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,715.35 / $4,570.88 / $4,786.30
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,570.88 / $4,786.30 / $4,786.30
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $6,918.31 / $9,549.93
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $4,570.88
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,570.88 / $4,570.88 / $4,570.88
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,073.80 / $5,370.32
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $5,623.41 / $6,760.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,754.23 / $3,981.07
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $4,073.80 / $7,244.36