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Knee Joints, Polycentric, Below-Knee

Hawaii rates for HCPCS L5677

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

Rates data updated July 2026.

Facilitymedian $398 · 10th–90th $389$8510%20%40%10th90th$398Professionalmedian $1,096 · 10th–90th $219$1,1480%50%10th90th$1,096$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$331.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$851.14
Cigna
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$1,000.00
Typical High
$1,348.96
HMSA
Setting
Professional
Modifier
Global
Typical Low
$1,096.48
Median
$1,096.48
Typical High
$1,148.15
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$1,096.48
Typical High
$1,513.56
United
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$398.11
Typical High
$467.74
United
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$489.78
Typical High
$1,318.26