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Knee Joints, Polycentric, Below-Knee

New Hampshire rates for HCPCS L5677

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

Rates data updated July 2026.

Facilitymedian $813 · 10th–90th $447$9770%20%40%10th90th$813Professionalmedian $537 · 10th–90th $295$6920%20%10th90th$537$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
Facility
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$537.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$446.68
Typical High
$537.03
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$812.83
Median
$851.14
Typical High
$977.24
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$363.08
Typical High
$363.08
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$575.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$398.11
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$691.83
Typical High
$1,288.25
United
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$407.38
Typical High
$446.68
United
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$457.09
Typical High
$691.83
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$1,122.02