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Arizona rates for HCPCS L5628

Addition to lower extremity, test socket, hemipelvectomy

Facilitymedian $490 · 10th–90th $178–$1,2300%10%10th90th$490Professionalmedian $347 · 10th–90th $263–$6460%20%10th90th$347$0.5$2.0$10.0$50.0$200.0$1.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $346.74 / $645.65
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $630.96 / $1,174.90
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $575.44 / $1,122.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $501.19
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $426.58 / $3,090.30
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $288.40 / $3,630.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $446.68 / $478.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $288.40 / $436.52