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Virginia rates for HCPCS L5626

Addition to lower extremity, test socket, hip disarticulation

Facilitymedian $692 · 10th–90th $363–$8510%20%40%10th90th$692Professionalmedian $363 · 10th–90th $282–$6310%20%40%10th90th$363$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
$363.08 / $363.08 / $363.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $363.08 / $457.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $741.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $724.44
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $478.63
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $489.78 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $457.09
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $691.83 / $977.24
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $457.09 / $691.83
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $446.68 / $794.33
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $371.54 / $457.09
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $575.44 / $1,513.56
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $575.44 / $1,513.56
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $426.58 / $691.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $338.84 / $537.03