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Texas rates for HCPCS L5622

Addition to lower extremity, test socket, knee disarticulation

Facilitymedian $437 · 10th–90th $240–$1,3490%10%10th90th$437Professionalmedian $263 · 10th–90th $200–$5130%20%40%10th90th$263$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
$251.19 / $251.19 / $275.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $263.03 / $478.63
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,388.44 / $4,168.69
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $588.84 / $588.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $371.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $275.42
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
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $436.52 / $724.44
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $269.15 / $562.34
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $346.74
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $436.52 / $724.44
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $275.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $331.13 / $501.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $269.15 / $331.13
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $588.84 / $588.84