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Texas rates for HCPCS L5658

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

Facilitymedian $355 · 10th–90th $191$9770%10%10th90th$355Professionalmedian $224 · 10th–90th $191$3800%20%10th90th$224$0.5$2.0$10.0$50.0$200.0$1.0K

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
$190.55 / $190.55 / $204.17
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $223.87 / $380.19
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $446.68 / $446.68
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $363.08
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,344.23 / $2,344.23
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $3,548.13 / $3,548.13
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $363.08 / $630.96
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $245.47 / $489.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $239.88
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $363.08 / $630.96
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $363.08
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $338.84 / $501.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $269.15 / $331.13
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $446.68 / $446.68