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Washington rates for HCPCS L5250

Hip disarticulation, Canadian type; molded socket, hip joint, single axis constant friction knee, shin, SACH foot

Facilitymedian $7,762 · 10th–90th $4,898–$16,5960%20%10th90th$7,762Professionalmedian $5,012 · 10th–90th $2,951–$10,2330%10%20%10th90th$5,012$1.0$10.0$100.0$1.0K$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
$5,011.87 / $5,011.87 / $11,748.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,715.35 / $6,456.54
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $7,585.78 / $7,585.78
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,606.93 / $6,606.93 / $8,709.64
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,365.16 / $4,365.16 / $4,365.16
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $4,365.16
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,890.45 / $8,912.51 / $21,877.62
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $8,709.64 / $14,454.40
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $5,888.44 / $6,456.54
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,165.95 / $7,585.78 / $7,762.47
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,244.36 / $7,762.47 / $7,762.47
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,760.83 / $11,220.18 / $15,488.17
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,309.57 / $6,309.57 / $7,585.78
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $7,585.78 / $7,585.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,606.93 / $6,606.93 / $8,709.64
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $8,511.38 / $10,232.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $4,168.69 / $5,888.44
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $6,606.93 / $11,748.98