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Knee Joints, Polycentric, Below-Knee

Wisconsin rates for HCPCS L5677

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

Rates data updated July 2026.

Facilitymedian $676 · 10th–90th $537$1,2300%50%10th90th$676Professionalmedian $631 · 10th–90th $331$1,1220%20%10th90th$631$0.5$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$338.84
Median
$338.84
Typical High
$338.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$588.84
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$676.08
Typical High
$1,122.02
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$758.58
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$1,548.82
Typical High
$3,467.37
Cigna
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$977.24
Typical High
$1,288.25
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$549.54
Typical High
$831.76
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$812.83
Typical High
$1,000.00
Medica
Setting
Facility
Modifier
Global
Typical Low
$338.84
Median
$660.69
Typical High
$3,162.28
Medica
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$426.58
Typical High
$758.58
Molina
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$70.79
Typical High
$398.11
Network Health
Setting
Facility
Modifier
Global
Typical Low
$1,071.52
Median
$1,071.52
Typical High
$1,071.52
Network Health
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$758.58
Typical High
$1,318.26
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$549.54
Typical High
$831.76
Prevea360
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$660.69
Typical High
$794.33
Quartz
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$1,023.29
Typical High
$1,778.28
Quartz
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$1,380.38
Typical High
$3,162.28
Quartz
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$1,023.29
Typical High
$4,466.84
United
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$446.68
Typical High
$676.08
United
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$338.84
Typical High
$616.60