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Washington rates for HCPCS L5626

Addition to lower extremity, test socket, hip disarticulation

Facilitymedian $661 · 10th–90th $427–$1,4130%20%10th90th$661Professionalmedian $427 · 10th–90th $282–$9330%10%20%10th90th$427$1.0$5.0$20.0$100.0$500.0$2.0K

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
$426.58 / $426.58 / $1,000.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $346.74 / $645.65
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $645.65 / $645.65
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $741.31
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
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $812.83 / $1,862.09
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $776.25 / $1,318.26
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $501.19 / $549.54
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $645.65 / $660.69
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $575.44 / $660.69
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $954.99 / $1,318.26
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $645.65
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $645.65
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $741.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $776.25 / $933.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $380.19 / $549.54
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $575.44 / $1,000.00