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Nationwide rates for HCPCS L5628

Addition to lower extremity, test socket, hemipelvectomy

Facilitymedian $490 · 10th–90th $275–$1,5140%10%10th90th$490Professionalmedian $380 · 10th–90th $263–$7760%20%10th90th$380$0.5$5.0$50.0$500.0$5.0K$50.0K$500.0K

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
$269.15 / $346.74 / $645.65
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $346.74 / $602.56
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $363.08 / $1,380.38
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $389.05 / $794.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $501.19 / $2,884.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $1,122.02
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $436.52 / $794.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $338.84 / $575.44

See more rates by state

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