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Washington rates for HCPCS L5580

Preparatory, above knee (AK), knee disarticulation, ischial level socket, nonalignable system, pylon, no cover, SACH foot, thermoplastic or equal, molded to model

Facilitymedian $3,162 · 10th–90th $2,042–$7,4130%20%10th90th$3,162Professionalmedian $2,138 · 10th–90th $1,288–$4,5710%20%10th90th$2,138$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
$2,041.74 / $2,041.74 / $4,786.30
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,698.24 / $2,818.38
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $3,019.95 / $3,019.95
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $3,467.37
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $1,778.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,288.25 / $1,778.28
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $3,981.07 / $8,912.51
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $3,715.35 / $6,606.93
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $2,398.83 / $2,630.27
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,019.95 / $3,388.44
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,630.27 / $3,467.37
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $4,570.88 / $6,309.57
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,570.40 / $3,019.95
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,019.95 / $3,019.95
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $3,467.37
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,862.09 / $3,890.45 / $4,570.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,905.46 / $2,691.53
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $2,691.53 / $4,786.30