go back

Washington rates for HCPCS L5654

Addition to lower extremity, socket insert, Symes, (Kemblo, Pelite, Aliplast, Plastazote or equal)

Facilitymedian $468 · 10th–90th $302$1,0470%20%10th90th$468Professionalmedian $302 · 10th–90th $195$6610%10%20%10th90th$302$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
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$724.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$239.88
Typical High
$398.11
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$457.09
Typical High
$457.09
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$524.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$309.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$223.87
Typical High
$309.03
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$588.84
Typical High
$1,318.26
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$549.54
Typical High
$912.01
Molina
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$354.81
Typical High
$389.05
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$457.09
Typical High
$467.74
Pacific Source
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$416.87
Typical High
$467.74
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$676.08
Typical High
$933.25
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$389.05
Typical High
$457.09
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$457.09
Typical High
$457.09
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$524.81
United
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$537.03
Typical High
$645.65
United
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$263.03
Typical High
$380.19
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$407.38
Typical High
$707.95