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Wisconsin rates for HCPCS L5250

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

Facilitymedian $6,918 · 10th–90th $5,623–$12,5890%50%10th90th$6,918Professionalmedian $5,012 · 10th–90th $2,951–$10,2330%20%10th90th$5,012$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$3,388.44 / $3,388.44 / $3,388.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,388.44 / $5,754.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,918.31 / $6,918.31 / $11,481.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,456.54 / $6,456.54 / $7,762.47
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,365.16 / $15,848.93 / $33,884.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $9,772.37 / $12,882.50
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,388.44 / $5,623.41 / $8,511.38
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $6,760.83 / $8,317.64
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,388.44 / $6,760.83 / $33,113.11
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $4,466.84 / $7,762.47
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $4,168.69
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,964.78 / $10,964.78 / $10,964.78
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,897.79 / $7,762.47 / $13,489.63
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,918.31 / $10,232.93 / $19,498.45
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,365.16 / $13,803.84 / $39,810.72
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $6,309.57 / $46,773.51
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,677.35 / $6,918.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,691.53 / $3,467.37 / $5,754.40