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New York rates for HCPCS L5622

Addition to lower extremity, test socket, knee disarticulation

Facilitymedian $363 · 10th–90th $251–$1,0720%20%10th90th$363Professionalmedian $275 · 10th–90th $200–$8130%20%10th90th$275$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$213.80 / $467.74 / $660.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $263.03 / $389.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $1,174.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $891.25
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $478.63 / $478.63
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $575.44
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $977.24 / $2,290.87
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $588.84 / $1,122.02
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $281.84
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $346.74 / $371.54
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $562.34 / $562.34
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $323.59 / $1,318.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $363.08 / $977.24
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $331.13 / $346.74
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $346.74 / $371.54