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Knee Joints, Polycentric, Below-Knee

Washington rates for HCPCS L5677

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

Rates data updated July 2026.

Facilitymedian $646 · 10th–90th $417$1,4450%20%10th90th$646Professionalmedian $537 · 10th–90th $295$1,1750%10%10th90th$537$5.0$20.0$100.0$500.0$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
$416.87
Median
$416.87
Typical High
$1,000.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$416.87
Typical High
$3,467.37
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$630.96
Typical High
$645.65
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$724.44
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
$295.12
Typical High
$398.11
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$870.96
Typical High
$1,819.70
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$758.58
Typical High
$1,380.38
Molina
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$489.78
Typical High
$549.54
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$630.96
Typical High
$645.65
Pacific Source
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$588.84
Typical High
$645.65
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$954.99
Typical High
$1,288.25
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$537.03
Typical High
$630.96
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$645.65
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$724.44
United
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$812.83
Typical High
$954.99
United
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$426.58
Typical High
$575.44
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$562.34
Typical High
$977.24