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Knee Joints, Polycentric, Below-Knee

Pennsylvania rates for HCPCS L5677

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

Rates data updated July 2026.

Facilitymedian $813 · 10th–90th $263$1,9050%20%10th90th$813Professionalmedian $295 · 10th–90th $245$5620%20%40%10th90th$295$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$263.03
Median
$263.03
Typical High
$1,023.29
Aetna
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$288.40
Typical High
$537.03
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$478.63
Typical High
$602.56
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$912.01
Cigna
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$398.11
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$794.33
Typical High
$1,148.15
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$602.56
Typical High
$602.56
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$426.58
Typical High
$602.56
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$263.03
Typical High
$1,023.29
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$288.40
Typical High
$537.03
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$537.03
Typical High
$537.03
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$1,318.26
Typical High
$2,290.87
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$562.34
Typical High
$630.96
United
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$812.83
Typical High
$812.83
United
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$346.74
Typical High
$616.60