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Nebraska rates for HCPCS L5628

Addition to lower extremity, test socket, hemipelvectomy

Facilitymedian $661 · 10th–90th $380–$3,0900%20%10th90th$661Professionalmedian $389 · 10th–90th $219–$1,6220%20%10th90th$389$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
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $389.05 / $389.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $389.05 / $2,511.89
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $588.84 / $588.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $676.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $851.14 / $1,122.02
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $676.08 / $3,090.30
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $371.54 / $630.96
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $1,621.81
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $676.08
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,513.56 / $1,621.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $436.52 / $676.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $302.00 / $478.63