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Washington rates for HCPCS L5210

Above knee (AK), short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each

Facilitymedian $3,890 · 10th–90th $2,291–$7,7620%20%10th90th$3,890Professionalmedian $2,512 · 10th–90th $1,380–$4,8980%10%10th90th$2,512$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
$2,511.89 / $2,511.89 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,737.80 / $3,235.94
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,388.44 / $3,801.89 / $3,801.89
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $3,388.44 / $4,365.16
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,819.70 / $1,819.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $1,819.70
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $4,365.16 / $10,964.78
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $4,168.69 / $6,760.83
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $2,951.21 / $3,311.31
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,801.89 / $3,890.45
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $3,890.45
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,388.44 / $5,623.41 / $7,762.47
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,235.94 / $3,235.94 / $3,801.89
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,801.89 / $3,801.89 / $3,801.89
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $3,388.44 / $4,365.16
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $3,981.07 / $4,786.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,949.84 / $2,754.23
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $3,388.44 / $5,888.44