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Ohio rates for HCPCS L5628

Addition to lower extremity, test socket, hemipelvectomy

Facilitymedian $832 · 10th–90th $389$1,3800%20%40%10th90th$832Professionalmedian $380 · 10th–90th $263$6460%20%40%10th90th$380$0.5$2.0$10.0$50.0$200.0$1.0K

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
$380.19 / $380.19 / $512.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $346.74 / $512.86
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $831.76 / $1,698.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $467.74 / $1,023.29
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $524.81 / $741.31
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $549.54 / $831.76
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 / $501.19
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $501.19
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $501.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $467.74 / $676.08
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $954.99
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $891.25 / $1,621.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $478.63 / $794.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $371.54 / $489.78