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Washington rates for HCPCS L5505

Initial, above knee (AK), knee disarticulation, ischial level socket, nonalignable system, pylon, no cover, SACH foot, plaster socket, direct formed

Facilitymedian $2,138 · 10th–90th $1,445–$5,1290%20%10th90th$2,138Professionalmedian $1,585 · 10th–90th $1,023–$3,3110%10%20%10th90th$1,585$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
$1,348.96 / $1,348.96 / $3,235.94
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,258.93 / $2,089.30
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,041.74 / $2,041.74
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,819.70 / $2,344.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,621.81 / $1,621.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,174.90 / $1,621.81
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $3,090.30 / $6,025.60
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,691.53 / $4,786.30
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $1,584.89 / $1,778.28
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,041.74 / $2,089.30
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $2,344.23
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $3,090.30 / $4,168.69
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $2,041.74
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,041.74 / $2,041.74
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,819.70 / $2,344.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,818.38 / $3,388.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,380.38 / $1,995.26
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,819.70 / $3,162.28