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Test Socket, Hemipelvectomy

Illinois rates for HCPCS L5628

Addition to lower extremity, test socket, hemipelvectomy

Rates data updated July 2026.

Facilitymedian $794 · 10th–90th $380$3,9810%20%10th90th$794Professionalmedian $389 · 10th–90th $302$8510%20%40%10th90th$389$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
Setting
Facility
Modifier
Global
Typical Low
$380.19
Median
$380.19
Typical High
$794.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$380.19
Typical High
$794.33
BCBS
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$1,513.56
Typical High
$5,370.32
BCBS
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$602.56
Typical High
$602.56
Cigna
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$501.19
Typical High
$676.08
Cigna
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$363.08
Typical High
$776.25
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$1,148.15
Typical High
$1,412.54
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,000.00
Typical High
$1,000.00
Molina
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$436.52
Typical High
$616.60
United
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$630.96
Typical High
$794.33
United
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$389.05
Typical High
$630.96