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Washington rates for HCPCS L5613

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

Facilitymedian $3,162 · 10th–90th $1,950–$7,5860%20%10th90th$3,162Professionalmedian $2,239 · 10th–90th $1,380–$4,6770%20%10th90th$2,239$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
$1,905.46 / $1,905.46 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,778.28 / $2,630.27
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,884.03 / $2,884.03
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,570.40 / $3,311.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $1,905.46
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,862.09 / $4,168.69 / $8,511.38
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $3,715.35 / $6,760.83
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $2,238.72 / $2,454.71
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,951.21 / $3,630.78
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $4,265.80 / $5,888.44
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,454.71 / $2,884.03
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $2,884.03
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,570.40 / $3,311.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $3,981.07 / $4,786.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,949.84 / $2,818.38
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,570.40 / $4,466.84