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Texas rates for HCPCS L5626

Addition to lower extremity, test socket, hip disarticulation

Facilitymedian $501 · 10th–90th $282–$1,4130%10%20%10th90th$501Professionalmedian $339 · 10th–90th $251–$5620%20%10th90th$339$0.5$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$281.84 / $281.84 / $302.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $316.23 / $562.34
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $446.68
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $645.65 / $645.65
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $489.78
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $3,162.28
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,467.37 / $4,265.80 / $4,265.80
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $512.86 / $831.76
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $338.84 / $645.65
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $371.54
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $501.19 / $812.83
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $489.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $436.52 / $660.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $354.81 / $436.52
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $645.65 / $645.65