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Virginia rates for HCPCS L5637

Addition to lower extremity, below knee (BK), total contact

Rates data updated July 2026.

How much does HCPCS L5637 cost?

$219

Typical negotiated rate. In Virginia, July 2026.

Insurers have agreed to pay about $219 for this service. The price depends on where it is billed: about $214 from a physician practice, and about $417 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$214$209 to $263
FacilityA hospital or hospital-owned outpatient department$417$269 to $417

How much rates vary

Facilitymedian $417 · 10th to 90th $214 to $525Professionalmedian $214 · 10th to 90th $182 to $355
$200$500$1K$2K$5K$10Kfacility $417professional $214

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$218.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$213.80
Typical High
$223.87
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$416.87
Typical High
$446.68
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$436.52
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$288.40
Cigna
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$234.42
Typical High
$234.42
Cigna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$234.42
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$416.87
Typical High
$588.84
Medcost
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$275.42
Typical High
$407.38
Medcost
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$269.15
Typical High
$478.63
Medcost
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$263.03
Typical High
$269.15
Sentara
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$338.84
Typical High
$1,202.26
Sentara
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$338.84
Typical High
$1,202.26
United
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$257.04
Typical High
$467.74
United
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$204.17
Typical High
$323.59

Where Virginia sits

The same service costs 2.7 times more in Hawaii than in Delaware. 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.

Virginia· 33rd of 51

$219

HI $490DE $182

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.