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Knee Joints, Polycentric, Below-Knee

Montana rates for HCPCS L5677

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

Rates data updated July 2026.

Facilitymedian $575 · 10th–90th $407$8510%20%40%10th90th$575Professionalmedian $501 · 10th–90th $191$1,1220%10%20%10th90th$501$100.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$501.19
Typical High
$3,467.37
BCBS
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$575.44
Typical High
$575.44
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$616.60
Typical High
$616.60
Cigna
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$616.60
Typical High
$616.60
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$575.44
Typical High
$1,122.02
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$575.44
Typical High
$1,122.02
Providence
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$588.84
Typical High
$912.01
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$467.74
Typical High
$616.60
United
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$446.68
Typical High
$467.74
United
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$295.12
Typical High
$457.09