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Washington rates for HCPCS L5656

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

Facilitymedian $589 · 10th–90th $347–$1,1750%20%10th90th$589Professionalmedian $389 · 10th–90th $200–$7410%10%10th90th$389$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
$389.05 / $389.05 / $912.01
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $269.15 / $501.19
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $575.44 / $575.44
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $660.69
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $338.84
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $660.69 / $1,659.59
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $645.65 / $1,023.29
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $457.09 / $501.19
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $575.44 / $588.84
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $467.74 / $741.31
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $870.96 / $1,174.90
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $575.44
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $575.44
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $512.86 / $660.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $724.44 / $724.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $295.12 / $426.58
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $512.86 / $912.01