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
Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.
| Hospital | Medicare Advantage rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $582 – $640 | — | — |
| Deaconess Medical Center | $582 – $640 | — | — |
| Harborview Medical Center | $594 – $653 | $710 – $727 | $1,014 – $1,039 |
| Kadlec Regional Medical Center | $594 – $712 | — | — |
| Mary Bridge Children's Hospital | $582 – $640 | — | — |
| MultiCare Auburn Medical Center | $582 – $640 | — | — |
| MultiCare Covington Medical Center | $582 – $640 | — | — |
| MultiCare Good Samaritan Hospital | $582 – $640 | — | — |
| MultiCare Valley Hospital | $599 – $640 | — | — |
| Overlake Hospital Medical Center & Clinics | $594 – $617 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $594 – $712 | — | — |
| Providence Centralia Hospital | $594 – $950 | — | — |
| Providence Regional Medical Center Everett | $594 – $653 | — | — |
| Providence St Peter Hospital | $594 – $950 | — | — |
| Seattle Children's Hospital | — | $1,771 – $2,718 | $1,771 – $2,718 |
| Swedish Edmonds Hospital | $594 – $712 | — | — |
| Swedish Issaquah | $594 – $712 | — | — |
| Swedish Medical Center | $594 – $712 | — | — |
| Swedish Medical Center / Cherry Hill | $594 – $712 | — | — |
| Tacoma General Allenmore Hospital | $582 – $640 | — | — |
| University of Washington Medical Ctr | $594 – $653 | — | — |
| Virginia Mason Medical Center | $407 – $611 | — | — |
| Wellfound Behavioral Health Hospital | — | — | — |
| Yakima Valley Memorial | $582 – $651 | — | — |
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)