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Test Socket, Hemipelvectomy

Wisconsin rates for HCPCS L5628

Addition to lower extremity, test socket, hemipelvectomy

Rates data updated October 2026.

How much does Test Socket, Hemipelvectomy cost?

$776

Typical negotiated rate. In Wisconsin, October 2026.

Insurers have agreed to pay about $776 for this service. The price depends on where it is billed: about $741 from a physician practice, and about $794 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 9 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$741$437 to $871
FacilityA hospital or hospital-owned outpatient department$794$776 to $1,175

How much rates vary

Facilitymedian $794 · 10th to 90th $501 to $1,698Professionalmedian $741 · 10th to 90th $363 to $1,175
$200$500$1K$2Kfacility $794professional $741

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$776.25
Median
$776.25
Typical High
$776.25
Aetna
Setting
Professional
Modifier
None
Typical Low
$776.25
Median
$776.25
Typical High
$1,778.28
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$794.33
Median
$891.25
Typical High
$1,288.25
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$354.81
Median
$794.33
Typical High
$977.24
Cigna
Setting
Facility
Modifier
None
Typical Low
$501.19
Median
$1,584.89
Typical High
$3,311.31
Cigna
Setting
Professional
Modifier
None
Typical Low
$363.08
Median
$537.03
Typical High
$1,479.11
DeanCare
Setting
Facility
Modifier
None
Typical Low
$186.21
Median
$776.25
Typical High
$891.25
DeanCare
Setting
Professional
Modifier
None
Typical Low
$446.68
Median
$707.95
Typical High
$933.25
Medica
Setting
Facility
Modifier
None
Typical Low
$323.59
Median
$776.25
Typical High
$3,090.30
Medica
Setting
Professional
Modifier
None
Typical Low
$346.74
Median
$446.68
Typical High
$3,630.78
Network Health
Setting
Facility
Modifier
None
Typical Low
$1,258.93
Median
$1,258.93
Typical High
$1,258.93
Network Health
Setting
Professional
Modifier
None
Typical Low
$562.34
Median
$724.44
Typical High
$1,348.96
Prevea360
Setting
Facility
Modifier
None
Typical Low
$186.21
Median
$776.25
Typical High
$891.25
Prevea360
Setting
Professional
Modifier
None
Typical Low
$446.68
Median
$575.44
Typical High
$776.25
Quartz
Setting
Professional
Modifier
None
Typical Low
$645.65
Median
$1,047.13
Typical High
$1,479.11
Quartz
Setting
Facility
Modifier
None
Typical Low
$501.19
Median
$501.19
Typical High
$512.86
Quartz
Setting
Professional
Modifier
None
Typical Low
$363.08
Median
$363.08
Typical High
$501.19
United
Setting
Facility
Modifier
None
Typical Low
$229.09
Median
$288.40
Typical High
$954.99
United
Setting
Professional
Modifier
None
Typical Low
$257.04
Median
$436.52
Typical High
$660.69
6 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$389.05
Median
$389.05
Typical High
$870.96
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$154.88
Median
$154.88
Typical High
$354.81
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$114.82
Median
$114.82
Typical High
$263.03
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$77.62
Median
$77.62
Typical High
$177.83
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$35.48
Median
$35.48
Typical High
$100.00
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$263.03
Median
$263.03
Typical High
$288.40

Where Wisconsin sits

The same service costs 2.3 times more in Wisconsin than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Wisconsin· 1st of 51

$776

WI $776FL $339

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.