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South Carolina rates for HCPCS L5628

Addition to lower extremity, test socket, hemipelvectomy

Facilitymedian $437 · 10th–90th $275–$8130%10%20%10th90th$437Professionalmedian $355 · 10th–90th $257–$5130%20%10th90th$355$50.0$100.0$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
$275.42 / $275.42 / $275.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $338.84 / $467.74
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $616.60 / $724.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $501.19 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $831.76
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $389.05
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $478.63 / $977.24
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $190.55
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $436.52 / $794.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $302.00 / $436.52