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Pennsylvania rates for HCPCS L5622

Addition to lower extremity, test socket, knee disarticulation

Facilitymedian $589 · 10th–90th $229–$8710%20%10th90th$589Professionalmedian $251 · 10th–90th $200–$4070%20%10th90th$251$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
$229.09 / $870.96 / $870.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $251.19 / $380.19
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $416.87 / $524.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $436.52
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $275.42
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $776.25 / $1,122.02
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $363.08 / $524.81
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $380.19
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $229.09
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $251.19 / $363.08
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $831.76 / $1,148.15
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $489.78
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $489.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $588.84 / $676.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $288.40 / $537.03