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Idaho rates for HCPCS L5628

Addition to lower extremity, test socket, hemipelvectomy

Facilitymedian $646 · 10th–90th $363–$8710%20%10th90th$646Professionalmedian $468 · 10th–90th $269–$8130%10%10th90th$468$50.0$100.0$200.0$500.0$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 / $436.52 / $602.56
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $691.83 / $1,174.90
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $812.83 / $812.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $501.19 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $501.19
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $575.44 / $776.25
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $707.95 / $741.31
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $630.96
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $707.95 / $707.95
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $776.25
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $741.31 / $741.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $436.52 / $446.68
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $288.40 / $446.68