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Washington rates for HCPCS L5629

Addition to lower extremity, below knee, acrylic socket

Facilitymedian $380 · 10th–90th $263–$9330%20%10th90th$380Professionalmedian $275 · 10th–90th $182–$6030%20%10th90th$275$1.0$5.0$20.0$100.0$500.0$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
$245.47 / $467.74 / $588.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $229.09 / $331.13
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $295.12
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $371.54 / $371.54
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $426.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $245.47
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $537.03 / $1,096.48
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $489.78 / $891.25
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $295.12 / $323.59
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $371.54 / $380.19
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $416.87
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $562.34 / $758.58
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $371.54
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $371.54
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $426.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $512.86 / $616.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $251.19 / $363.08
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $331.13 / $588.84