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Texas rates for HCPCS L5638

Addition to lower extremity, below knee (BK), leather socket

Facilitymedian $490 · 10th–90th $263–$1,5850%10%20%10th90th$490Professionalmedian $331 · 10th–90th $257–$5250%20%40%10th90th$331$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
$263.03 / $263.03 / $288.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $302.00 / $524.81
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $616.60 / $616.60
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $501.19
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $3,162.28
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $5,248.07 / $5,248.07
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $489.78 / $870.96
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $331.13 / $645.65
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $331.13
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $501.19 / $851.14
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $501.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $446.68 / $676.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $363.08 / $446.68
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $616.60 / $616.60