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Joint Covers, Below-Knee

Ohio 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?

$28.18

Typical negotiated rate. In Ohio, July 2026.

Insurers have agreed to pay about $28.18 for this service. The price depends on where it is billed: about $25.70 from a physician practice, and about $51.29 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 8 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$25.70$23.44 to $34.67
FacilityA hospital or hospital-owned outpatient department$51.29$39.81 to $56.23

How much rates vary

Facilitymedian $51 · 10th to 90th $24 to $83Professionalmedian $26 · 10th to 90th $22 to $56
$20$50$100facility $51professional $26

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
$23.44
Median
$23.44
Typical High
$44.67
Aetna
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$23.44
Typical High
$39.81
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$51.29
Typical High
$104.71
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$28.84
Typical High
$63.10
CareSource
Setting
Facility
Modifier
Global
Typical Low
$23.99
Median
$40.74
Typical High
$57.54
CareSource
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$42.66
Typical High
$64.57
Cigna
Setting
Facility
Modifier
Global
Typical Low
$29.51
Median
$29.51
Typical High
$33.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$21.88
Median
$21.88
Typical High
$33.11
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$29.51
Median
$29.51
Typical High
$31.62
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$21.88
Median
$21.88
Typical High
$29.51
Molina
Setting
Professional
Modifier
Global
Typical Low
$20.89
Median
$28.84
Typical High
$41.69
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$54.95
Typical High
$100.00
United
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$38.90
Typical High
$54.95
United
Setting
Professional
Modifier
Global
Typical Low
$15.85
Median
$23.99
Typical High
$36.31

Where Ohio 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.

Ohio· 34th of 51

$28.18

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.