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Illinois rates for HCPCS L5628

Addition to lower extremity, test socket, hemipelvectomy

Facilitymedian $871 · 10th–90th $380–$3,9810%20%10th90th$871Professionalmedian $380 · 10th–90th $263–$7940%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
$380.19 / $380.19 / $794.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $380.19 / $645.65
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $1,513.56 / $5,370.32
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $588.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $676.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $776.25
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $1,148.15 / $1,412.54
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $1,000.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $616.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $630.96 / $954.99
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $389.05 / $575.44