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Test Socket, Knee Disarticulation

Utah rates for HCPCS L5622

Addition to lower extremity, test socket, knee disarticulation

Rates data updated July 2026.

Facilitymedian $229 · 10th–90th $141$4370%20%40%10th90th$229Professionalmedian $269 · 10th–90th $141$1,9950%10%20%10th90th$269$50.0$100.0$200.0$500.0$1.0K$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
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$141.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$251.19
Typical High
$1,995.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$275.42
Cigna
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$275.42
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$316.23
Typical High
$416.87
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$436.52
Typical High
$436.52
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$309.03
Typical High
$562.34
Select Health
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$446.68
Select Health
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$436.52
Typical High
$512.86
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$446.68
Typical High
$616.60
United
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$288.40
Typical High
$346.74
United
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$218.78
Typical High
$331.13