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Washington rates for HCPCS L5220

Above knee (AK), short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each

Facilitymedian $4,365 · 10th–90th $2,570–$8,7100%20%10th90th$4,365Professionalmedian $2,884 · 10th–90th $1,549–$5,4950%10%20%10th90th$2,884$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
$2,884.03 / $2,884.03 / $6,760.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,995.26 / $3,715.35
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,801.89 / $4,265.80 / $4,265.80
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $3,801.89 / $4,897.79
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,454.71 / $2,454.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,819.70 / $2,454.71
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $4,897.79 / $12,302.69
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $4,786.30 / $7,585.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $3,388.44 / $3,715.35
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $4,265.80 / $4,365.16
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,365.16 / $4,365.16 / $4,897.79
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,890.45 / $6,456.54 / $8,912.51
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,630.78 / $3,630.78 / $4,265.80
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $4,265.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $3,801.89 / $4,897.79
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $4,466.84 / $5,370.32
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,187.76 / $3,162.28
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $3,801.89 / $6,760.83