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Washington rates for HCPCS L5655

Addition to lower extremity, socket insert, below knee (BK) (Kemblo, Pelite, Aliplast, Plastazote or equal)

Facilitymedian $417 · 10th–90th $251–$8510%20%10th90th$417Professionalmedian $269 · 10th–90th $158–$5370%20%10th90th$269$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
$269.15 / $407.38 / $645.65
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $190.55 / $346.74
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $407.38 / $407.38
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $467.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $218.78
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $478.63 / $1,174.90
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $446.68 / $741.31
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $316.23 / $354.81
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $407.38 / $416.87
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $416.87 / $501.19
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $616.60 / $831.76
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $407.38
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $407.38
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $363.08 / $467.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $436.52 / $524.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $213.80 / $302.00
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $363.08 / $630.96