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Maryland rates for HCPCS L5628

Addition to lower extremity, test socket, hemipelvectomy

Facilitymedian $437 · 10th–90th $263–$5010%20%10th90th$437Professionalmedian $347 · 10th–90th $263–$5250%20%10th90th$347$200.0$500.0$1.0K$2.0K

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 / $346.74 / $524.81
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $457.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $467.74
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $660.69 / $1,000.00
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
$288.40 / $338.84 / $512.86
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $562.34