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Washington rates for HCPCS L5695

Addition to lower extremity, above knee (AK), pelvic control, sleeve suspension, neoprene or equal, each

Facilitymedian $200 · 10th–90th $135$4900%20%10th90th$200Professionalmedian $148 · 10th–90th $93$3090%20%10th90th$148$1.0$5.0$20.0$100.0$500.0

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
$125.89 / $125.89 / $302.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $117.49 / $177.83
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $190.55 / $190.55
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $218.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $123.03
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $275.42 / $562.34
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $251.19 / $457.09
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $151.36 / $165.96
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $190.55 / $234.42
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $204.17 / $239.88
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $288.40 / $389.05
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $190.55
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $218.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $269.15 / $316.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $128.82 / $186.21
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $169.82 / $302.00