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Oregon rates for HCPCS L5626

Addition to lower extremity, test socket, hip disarticulation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.92 / $399.18 / $1,891.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$493.58 / $493.58 / $493.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$360.31 / $360.31 / $493.58
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$459.43 / $1,212.33 / $1,581.20
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$399.18 / $546.88 / $656.33
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$488.01 / $616.95 / $689.15
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$520.98 / $590.70 / $656.33
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$572.26 / $656.33 / $656.33
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$399.18 / $570.83 / $689.15
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$360.31 / $574.71 / $721.96
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$546.82 / $1,091.46 / $2,302.63
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$564.44 / $721.96 / $721.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$915.61 / $915.61 / $1,220.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$272.77 / $285.49 / $544.67