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Test Socket, Knee Disarticulation

Wisconsin rates for HCPCS L5622

Addition to lower extremity, test socket, knee disarticulation

Rates data updated July 2026.

Facilitymedian $490 · 10th–90th $372$8910%20%40%10th90th$490Professionalmedian $457 · 10th–90th $240$8130%20%10th90th$457$0.5$2.0$10.0$50.0$200.0$1.0K

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
$245.47
Median
$245.47
Typical High
$245.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$245.47
Typical High
$436.52
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$812.83
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$457.09
Typical High
$549.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$1,122.02
Typical High
$2,511.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$707.95
Typical High
$933.25
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$398.11
Typical High
$602.56
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$691.83
Typical High
$870.96
Medica
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$478.63
Typical High
$2,344.23
Medica
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$309.03
Typical High
$549.54
Molina
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$70.79
Typical High
$295.12
Network Health
Setting
Facility
Modifier
Global
Typical Low
$776.25
Median
$776.25
Typical High
$776.25
Network Health
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$549.54
Typical High
$954.99
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$398.11
Typical High
$602.56
Prevea360
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$457.09
Typical High
$478.63
Quartz
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$741.31
Typical High
$1,288.25
Quartz
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$1,000.00
Typical High
$2,398.83
Quartz
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$724.44
Typical High
$2,951.21
United
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$323.59
Typical High
$489.78
United
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$251.19
Typical High
$446.68