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Oklahoma rates for HCPCS L5628

Addition to lower extremity, test socket, hemipelvectomy

Facilitymedian $380 · 10th–90th $295–$9330%20%10th90th$380Professionalmedian $339 · 10th–90th $263–$6030%10%20%10th90th$339$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
$295.12 / $295.12 / $295.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $338.84 / $457.09
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $602.56 / $602.56
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 / $363.08 / $660.69
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $436.52 / $2,137.96
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $331.13 / $851.14
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
$190.55 / $288.40 / $436.52