Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
C CS-BELOW KNEE TOTAL CONTACT
Tacoma, WA
See all hospitals reporting HCPCS L5637 →Price type
Mary Bridge Children's Hospital’s median price of $368 is 19% below the median hospital's median price ($457), higher than 27% of the 877 hospitals reporting HCPCS L5637. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 10 payers, 21 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | ||||
|---|---|---|---|---|
| 1 | Regence blue high performance fee schedule · outpatient | $305.33 | $305.33 | $305.33 – $305.33 |
| 2 | Regence mcc/ahn fee schedule · outpatient | $305.33 | $305.33 | $305.33 – $305.33 |
| 3 | Regence realvalue fee schedule · outpatient | $314.06 | $314.06 | $314.06 – $314.06 |
| 4 | Regence commercial fee schedule · outpatient | $348.95 | $348.95 | $348.95 – $348.95 |
| 5 | First Health all commercial plans percent of total billed charges · inpatientfrom % of charges | $367.35 | $367.35 | $367.35 – $367.35 |
| 6 | First Health all commercial plans percent of total billed charges · outpatientfrom % of charges | $367.35 | $367.35 | $367.35 – $367.35 |
| 7 | Aetna medadvantage fee schedule · outpatient | $367.90 | $367.90 | $367.90 – $367.90 |
| 8 | Regence medadvantage fee schedule · outpatient | $367.90 | $367.90 | $367.90 – $367.90 |
| 9 | Cigna all commercial plans percent of total billed charges · inpatientfrom % of charges | $370.19 | $370.19 | $370.19 – $370.19 |
| 10 | UnitedHealthcare medadvantage hmo fee schedule · outpatient | $371.47 | $371.47 | $371.47 – $371.47 |
| 11 | MultiPlan all commercial plans percent of total billed charges · inpatientfrom % of charges | $372.00 | $372.00 | $372.00 – $372.00 |
| 12 | MultiPlan all commercial plans percent of total billed charges · outpatientfrom % of charges | $372.00 | $372.00 | $372.00 – $372.00 |
| 13 | Molina medadvantage fee schedule · outpatient | $375.04 | $375.04 | $375.04 – $375.04 |
| 14 | WellCare medadvantage fee schedule · outpatient | $375.04 | $375.04 | $375.04 – $375.04 |
| 15 | Cigna all commercial plans percent of total billed charges · outpatientfrom % of charges | $378.51 | $378.51 | $378.51 – $378.51 |
| 16 | Premera hmo fee schedule · outpatient | $544.18 | $544.18 | $544.18 – $544.18 |
| 17 | Premera prime fee schedule · outpatient | $628.11 | $628.11 | $628.11 – $628.11 |
| 18 | Premera signature fee schedule · outpatient | $628.11 | $628.11 | $628.11 – $628.11 |
| 19 | Premera other commercial plans fee schedule · outpatient | $767.69 | $767.69 | $767.69 – $767.69 |
| 20 | Aetna all commercial plans fee schedule · outpatient | $1,104 | $1,104 | $1,104 – $1,104 |
| 21 | Kaiser hmo/ppo fee schedule · outpatient | $2,675 | $2,675 | $2,675 – $2,675 |
Last updated: Aug 27, 2026
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