go back

Virginia rates for HCPCS L5628

Addition to lower extremity, test socket, hemipelvectomy

Facilitymedian $661 · 10th–90th $339$8320%20%40%10th90th$661Professionalmedian $355 · 10th–90th $288$6030%50%10th90th$355$0.5$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$338.84 / $346.74 / $346.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $338.84 / $478.63
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $707.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $741.31
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $457.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $501.19 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $436.52
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $660.69 / $933.25
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $436.52 / $645.65
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $446.68 / $776.25
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $426.58
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $537.03 / $1,412.54
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $537.03 / $1,412.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $436.52 / $660.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $323.59 / $512.86