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North Carolina rates for HCPCS L5628

Addition to lower extremity, test socket, hemipelvectomy

Facilitymedian $501 · 10th–90th $263–$1,2020%20%10th90th$501Professionalmedian $447 · 10th–90th $263–$4680%20%40%10th90th$447$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$457.09 / $457.09 / $457.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $389.05 / $467.74
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $512.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $501.19 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $512.86
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $346.74 / $436.52
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $512.86 / $891.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $436.52 / $501.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $302.00 / $446.68
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $3,162.28
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,630.78 / $3,630.78 / $4,466.84