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Washington rates for HCPCS L5637

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

Facilitymedian $355 · 10th–90th $240–$8510%20%10th90th$355Professionalmedian $257 · 10th–90th $170–$5500%20%10th90th$257$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
$234.42 / $446.68 / $549.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $208.93 / $389.05
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $275.42 / $346.74
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $346.74 / $346.74
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $398.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $234.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $234.42
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $489.78 / $1,000.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $446.68 / $794.33
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $275.42 / $302.00
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $346.74 / $354.81
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $354.81 / $354.81
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $524.81 / $707.95
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $346.74
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $398.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $467.74 / $562.34
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $229.09 / $331.13
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $309.03 / $549.54