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Joint Covers, Below-Knee

North Carolina rates for HCPCS L5678

Additions to lower extremity, below knee (BK), joint covers, pair

Rates data updated July 2026.

How much does Joint Covers, Below-Knee cost?

$35.48

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $35.48 for this service. The price depends on where it is billed: about $35.48 from a physician practice, and about $38.02 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$35.48$26.30 to $36.31
FacilityA hospital or hospital-owned outpatient department$38.02$31.62 to $51.29

How much rates vary

Facilitymedian $38 · 10th to 90th $21 to $95Professionalmedian $35 · 10th to 90th $21 to $37
$20$50$100$200facility $38professional $35

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$35.48
Aetna
Setting
Professional
Modifier
Global
Typical Low
$20.42
Median
$35.48
Typical High
$36.31
BCBS
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$46.77
Typical High
$95.50
BCBS
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$36.31
Typical High
$39.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$21.38
Median
$29.51
Typical High
$31.62
Cigna
Setting
Professional
Modifier
Global
Typical Low
$21.88
Median
$21.88
Typical High
$33.11
Medcost
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$31.62
Typical High
$31.62
Medcost
Setting
Facility
Modifier
Global
Typical Low
$19.95
Median
$39.81
Typical High
$69.18
United
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$38.90
Typical High
$48.98
United
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$23.99
Typical High
$36.31
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$257.04
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$446.68

Where North Carolina sits

The same service costs 5.0 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

North Carolina· 15th of 51

$35.48

HI $107DE $21.38

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.