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Texas rates for HCPCS L5595

Preparatory, hip disarticulation/hemipelvectomy, pylon, no cover, SACH foot, thermoplastic or equal, molded to patient model

Facilitymedian $3,890 · 10th–90th $2,138–$19,0550%10%20%10th90th$3,890Professionalmedian $2,630 · 10th–90th $2,138–$4,2660%20%10th90th$2,630$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$2,137.96 / $2,137.96 / $2,290.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,511.89 / $4,265.80
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $4,897.79 / $4,897.79
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $3,548.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,630.27 / $3,548.13
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26,302.68 / $26,302.68 / $26,302.68
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45,708.82 / $45,708.82 / $45,708.82
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,981.07 / $6,918.31
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,691.53 / $5,248.07
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,630.27 / $2,691.53
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,801.89 / $6,918.31
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,630.27 / $3,548.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,801.89 / $5,623.41
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,951.21 / $3,715.35
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $4,897.79 / $4,897.79