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Washington rates for HCPCS L5617

Addition to lower extremity, quick change self-aligning unit, above knee (AK) or below knee (BK), each

Facilitymedian $661 · 10th–90th $427–$1,6220%20%10th90th$661Professionalmedian $468 · 10th–90th $295–$9770%20%10th90th$468$1.0$5.0$20.0$100.0$500.0$2.0K

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
$426.58 / $426.58 / $1,023.29
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $363.08 / $588.84
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $645.65 / $645.65
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $741.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $436.52
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $436.52
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $851.14 / $1,862.09
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $794.33 / $1,412.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $501.19 / $562.34
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $645.65 / $660.69
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $660.69 / $660.69
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $954.99 / $1,318.26
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $645.65
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $645.65
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $741.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $1,000.00 / $1,000.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $407.38 / $575.44
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $575.44 / $1,000.00