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Washington rates for HCPCS L5614

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

Facilitymedian $2,042 · 10th–90th $1,288–$4,7860%10%20%10th90th$2,042Professionalmedian $1,413 · 10th–90th $891–$2,9510%20%10th90th$1,413$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
$1,288.25 / $1,288.25 / $3,090.30
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,096.48 / $1,778.28
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,949.84 / $1,949.84
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $2,238.72
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $1,318.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $1,318.26
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $2,570.40 / $5,623.41
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $2,344.23 / $4,168.69
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $1,513.56 / $1,659.59
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,995.26 / $1,995.26
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,884.03 / $3,981.07
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $1,949.84
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $1,949.84
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $2,238.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $2,951.21 / $2,951.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,202.26 / $1,737.80
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,737.80 / $3,019.95