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Washington rates for HCPCS L5622

Addition to lower extremity, test socket, knee disarticulation

Facilitymedian $501 · 10th–90th $324$1,1480%20%10th90th$501Professionalmedian $324 · 10th–90th $204$7080%10%20%10th90th$324$1.0$5.0$20.0$100.0$500.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $776.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $263.03 / $426.58
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $489.78 / $489.78
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $562.34
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $275.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $275.42
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $616.60 / $1,412.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $588.84 / $1,000.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $389.05 / $426.58
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $489.78 / $501.19
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $501.19
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $741.31 / $1,000.00
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $489.78
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $489.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $562.34
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $588.84 / $707.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $288.40 / $416.87
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $436.52 / $776.25