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Texas rates for HCPCS L5613

Addition to lower extremity, endoskeletal system, above knee (AK), knee disarticulation, four-bar linkage, with hydraulic swing phase control

Facilitymedian $2,344 · 10th–90th $1,318–$7,7620%10%20%10th90th$2,344Professionalmedian $1,479 · 10th–90th $1,288–$2,6300%20%40%10th90th$1,479$2.0$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
$1,318.26 / $1,318.26 / $1,412.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,445.44 / $2,630.27
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $1,778.28
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $3,019.95 / $3,019.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,995.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $1,905.46
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15,848.93 / $15,848.93 / $15,848.93
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19,054.61 / $21,877.62 / $21,877.62
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,344.23 / $4,265.80
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,548.82 / $3,019.95
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $1,698.24
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,290.87 / $4,265.80
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $1,905.46
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,238.72 / $3,388.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,819.70 / $2,238.72
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $3,019.95 / $3,019.95