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Texas rates for HCPCS L5629

Addition to lower extremity, below knee, acrylic socket

Facilitymedian $372 · 10th–90th $219–$8510%10%20%10th90th$372Professionalmedian $240 · 10th–90th $182–$4170%50%10th90th$240$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
$223.87 / $223.87 / $239.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $229.09 / $426.58
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $363.08 / $389.05
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,388.44 / $4,168.69
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $239.88
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $389.05 / $512.86
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $245.47
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,041.74 / $2,041.74
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $3,801.89 / $3,801.89
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $380.19 / $537.03
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $234.42 / $467.74
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $295.12
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $380.19 / $537.03
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $245.47
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $295.12 / $436.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $234.42 / $288.40
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $512.86 / $512.86