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Washington rates for HCPCS L5694

Addition to lower extremity, above knee (AK), pelvic control belt, padded and lined

Facilitymedian $282 · 10th–90th $170–$5750%20%10th90th$282Professionalmedian $186 · 10th–90th $102–$3630%10%10th90th$186$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
$186.21 / $186.21 / $446.68
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $128.82 / $245.47
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $281.84 / $281.84
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $323.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $141.25
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $323.59 / $812.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $309.03 / $501.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $223.87 / $245.47
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $281.84 / $288.40
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $288.40
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $426.58 / $575.44
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $281.84
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $323.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $295.12 / $354.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $144.54 / $208.93
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $251.19 / $446.68