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New York rates for HCPCS L5628

Addition to lower extremity, test socket, hemipelvectomy

Facilitymedian $479 · 10th–90th $257–$1,0960%20%10th90th$479Professionalmedian $355 · 10th–90th $257–$8910%20%40%10th90th$355$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
$218.78 / $478.63 / $676.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $338.84 / $478.63
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $1,230.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $1,023.29
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $501.19 / $501.19
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $501.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $891.25
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $1,000.00 / $2,344.23
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $616.60 / $1,148.15
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $398.11
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $380.19 / $380.19
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $588.84 / $588.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $436.52 / $1,698.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $398.11 / $1,000.00
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $371.54 / $398.11
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $380.19 / $380.19