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Georgia rates for HCPCS L5628

Addition to lower extremity, test socket, hemipelvectomy

Facilitymedian $631 · 10th–90th $251–$2,2910%20%10th90th$631Professionalmedian $380 · 10th–90th $257–$6460%20%10th90th$380$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
$251.19 / $251.19 / $741.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $363.08 / $575.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $1,479.11 / $2,290.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $512.86 / $794.33
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
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 / $831.76
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $630.96 / $851.14
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $436.52 / $501.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $302.00 / $602.56