HCPCS L5658
Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)
Current code24 hospitals with prices
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $511 – $3,968 | — | — |
| Deaconess Medical Center | $710 – $2,470 | — | — |
| Harborview Medical Center | $950 – $1,187 | $710 – $727 | $1,014 – $1,039 |
| Kadlec Regional Medical Center | $895 – $1,667 | — | — |
| Mary Bridge Children's Hospital | $511 – $4,356 | — | — |
| MultiCare Auburn Medical Center | $497 – $2,564 | — | — |
| MultiCare Covington Medical Center | $497 – $2,564 | — | — |
| MultiCare Good Samaritan Hospital | $577 – $2,564 | — | — |
| MultiCare Valley Hospital | $568 – $2,465 | — | — |
| Overlake Hospital Medical Center & Clinics | $544 – $1,633 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $919 – $1,969 | — | — |
| Providence Centralia Hospital | $1,003 – $2,219 | — | — |
| Providence Regional Medical Center Everett | $712 – $1,377 | — | — |
| Providence St Peter Hospital | $504 – $1,938 | — | — |
| Seattle Children's Hospital | $956 – $2,609 | $1,771 – $2,718 | $1,771 – $2,718 |
| Swedish Edmonds Hospital | $890 – $2,177 | — | — |
| Swedish Issaquah | $890 – $1,318 | — | — |
| Swedish Medical Center | $890 – $2,120 | — | — |
| Swedish Medical Center / Cherry Hill | $890 – $2,120 | — | — |
| Tacoma General Allenmore Hospital | $497 – $2,564 | — | — |
| University of Washington Medical Ctr | $950 – $1,861 | — | — |
| Virginia Mason Medical Center | $568 – $2,064 | — | — |
| Wellfound Behavioral Health Hospital | $1,498 | — | — |
| Yakima Valley Memorial | $511 – $1,540 | — | — |
Medicare (traditional) reference
Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.
- Equipment fee, Washington
- $594 (fee)