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Pennsylvania rates for HCPCS L5626

Addition to lower extremity, test socket, hip disarticulation

Facilitymedian $692 · 10th–90th $302$1,1750%20%10th90th$692Professionalmedian $347 · 10th–90th $251$6460%20%10th90th$347$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$302.00 / $1,174.90 / $1,174.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $338.84 / $501.19
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $676.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $489.78
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $758.58 / $1,096.48
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $691.83
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $457.09 / $691.83
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $302.00
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $338.84 / $436.52
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $776.25 / $1,122.02
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $645.65
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $660.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $776.25 / $891.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $371.54 / $616.60