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Washington rates for HCPCS L5701

Replacement, socket, above knee (AK)/knee disarticulation, including attachment plate, molded to patient model

Facilitymedian $5,370 · 10th–90th $3,236$10,7150%20%10th90th$5,370Professionalmedian $3,467 · 10th–90th $1,862$6,7610%10%20%10th90th$3,467$1.0$10.0$100.0$1.0K$10.0K

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
$3,467.37 / $3,467.37 / $8,128.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,454.71 / $4,466.84
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,570.88 / $5,248.07 / $5,248.07
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,570.88 / $4,570.88 / $6,025.60
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,570.40 / $2,570.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $1,862.09 / $2,570.40
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $6,025.60 / $15,135.61
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $5,754.40 / $9,549.93
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $4,073.80 / $4,466.84
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $5,248.07 / $5,370.32
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,265.80 / $5,370.32 / $5,370.32
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $7,762.47 / $10,715.19
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $5,248.07
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,248.07 / $5,248.07 / $5,248.07
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,570.88 / $4,570.88 / $6,025.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $6,606.93 / $6,606.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,754.23 / $3,890.45
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $4,570.88 / $8,128.31