go back

Washington rates for HCPCS L5677

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

Facilitymedian $646 · 10th–90th $417–$1,5490%20%10th90th$646Professionalmedian $437 · 10th–90th $288–$9550%10%20%10th90th$437$1.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $1,000.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $354.81 / $562.34
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $630.96 / $630.96
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $724.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $398.11
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $870.96 / $1,819.70
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $776.25 / $1,380.38
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $489.78 / $549.54
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $630.96 / $645.65
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $645.65
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $954.99 / $1,288.25
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $537.03 / $630.96
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $630.96
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $724.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $812.83 / $954.99
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $398.11 / $562.34
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $562.34 / $977.24