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Knee Joints, Polycentric, Below-Knee

California rates for HCPCS L5677

Additions to lower extremity, below knee (BK), knee joints, polycentric, pair

Rates data updated July 2026.

Facilitymedian $347 · 10th–90th $269$1,5490%20%10th90th$347Professionalmedian $355 · 10th–90th $257$3,4670%20%10th90th$355$0.5$2.0$10.0$50.0$200.0$1.0K$5.0K

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
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$354.81
Typical High
$3,467.37
Aetna
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$354.81
Typical High
$3,467.37
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$346.74
Typical High
$1,548.82
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$363.08
Typical High
$891.25
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$1,258.93
Typical High
$1,949.84
Blue Shield
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$758.58
Typical High
$2,041.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$398.11
Typical High
$398.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$398.11
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$446.68
Typical High
$954.99
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$724.44
Typical High
$1,258.93
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$3,801.89
Median
$3,801.89
Typical High
$3,801.89
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$4,466.84
Median
$4,466.84
Typical High
$4,466.84
Molina
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$794.33
Typical High
$794.33
Optum
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$70.79
Providence
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$676.08
Typical High
$954.99
Providence
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$630.96
Sutter Health Plus
Setting
Professional
Modifier
Global
Typical Low
$1,479.11
Median
$1,479.11
Typical High
$1,479.11
The Alliance
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$478.63
Typical High
$724.44
United
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$398.11
Typical High
$812.83
United
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$354.81
Typical High
$812.83