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Indiana rates for HCPCS L5628

Addition to lower extremity, test socket, hemipelvectomy

Facilitymedian $794 · 10th–90th $355–$8320%20%40%10th90th$794Professionalmedian $363 · 10th–90th $275–$5370%50%10th90th$363$0.5$2.0$10.0$50.0$200.0$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
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $371.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $363.08 / $457.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $794.33 / $977.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $354.81 / $630.96
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $794.33 / $912.01
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $501.19 / $794.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $660.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $436.52 / $630.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $380.19 / $549.54