go back

Knee Joints, Polycentric, Below-Knee

Michigan rates for HCPCS L5677

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

Rates data updated July 2026.

Facilitymedian $813 · 10th–90th $380$2,6920%10%20%10th90th$813Professionalmedian $380 · 10th–90th $295$6610%20%10th90th$380$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
$380.19
Median
$380.19
Typical High
$380.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$354.81
Typical High
$446.68
BCBS
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$1,995.26
Typical High
$3,801.89
BCBS
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$660.69
Typical High
$691.83
CareSource
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$389.05
Typical High
$389.05
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$398.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$512.86
Typical High
$660.69
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$380.19
Median
$1,258.93
Typical High
$1,412.54
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$537.03
Typical High
$812.83
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$660.69
United
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$549.54
Typical High
$812.83
United
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$316.23
Typical High
$467.74