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California rates for HCPCS L5622

Addition to lower extremity, test socket, knee disarticulation

Facilitymedian $251 · 10th–90th $200$1,1480%20%40%10th90th$251Professionalmedian $269 · 10th–90th $200$1,7380%20%10th90th$269$0.5$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$263.03 / $263.03 / $1,995.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $263.03 / $1,737.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $251.19 / $1,071.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $707.95
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $660.69 / $1,071.52
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $851.14 / $1,698.24
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $275.42 / $275.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $275.42
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $186.21 / $562.34
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $467.74 / $831.76
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,398.83 / $2,398.83
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $4,365.16 / $4,365.16
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $575.44
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $436.52 / $616.60
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $478.63
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $851.14
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $194.98 / $416.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $288.40 / $588.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $263.03 / $489.78