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California rates for HCPCS L5628

Addition to lower extremity, test socket, hemipelvectomy

Facilitymedian $339 · 10th–90th $263$1,5140%20%10th90th$339Professionalmedian $372 · 10th–90th $263$2,2390%20%10th90th$372$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
$346.74 / $346.74 / $2,511.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $363.08 / $2,238.72
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $338.84 / $1,445.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $354.81 / $933.25
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $851.14 / $1,348.96
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $1,071.52 / $2,187.76
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $501.19 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $501.19
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $218.78 / $707.95
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $562.34 / $954.99
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
$3,630.78 / $4,466.84 / $4,466.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $691.83
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $575.44 / $794.33
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $691.83
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,096.48
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $223.87 / $537.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $380.19 / $794.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $346.74 / $645.65