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Michigan rates for HCPCS L5628

Addition to lower extremity, test socket, hemipelvectomy

Facilitymedian $794 · 10th–90th $437–$3,0900%10%20%10th90th$794Professionalmedian $380 · 10th–90th $263–$7760%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
$436.52 / $436.52 / $436.52
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $363.08 / $467.74
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $2,344.23 / $4,466.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $776.25 / $812.83
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $398.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $501.19 / $724.44
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $1,479.11 / $1,659.59
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $616.60 / $954.99
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $501.19
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $501.19 / $645.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $630.96 / $794.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $363.08 / $512.86