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Washington rates for HCPCS L5650

Additions to lower extremity, total contact, above knee (AK) or knee disarticulation socket

Facilitymedian $692 · 10th–90th $447–$1,5490%20%10th90th$692Professionalmedian $447 · 10th–90th $275–$9550%10%20%10th90th$447$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
$446.68 / $446.68 / $1,071.52
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $354.81 / $575.44
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $676.08 / $676.08
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $776.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $380.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $380.19
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $870.96 / $1,949.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $812.83 / $1,348.96
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $524.81 / $575.44
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $676.08 / $691.83
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $691.83 / $776.25
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $1,000.00 / $1,380.38
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $676.08
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $676.08
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $776.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $794.33 / $954.99
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $389.05 / $562.34
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $602.56 / $1,047.13