go back

Above-Knee Pelvic Control Belt, Light

Arizona rates for HCPCS L5692

Addition to lower extremity, above knee (AK), pelvic control belt, light

Rates data updated October 2026.

How much does Above-Knee Pelvic Control Belt, Light cost?

$100

Typical negotiated rate. In Arizona, October 2026.

Insurers have agreed to pay about $100 for this service. The price depends on where it is billed: about $95.50 from a physician practice, and about $214 from a hospital or other facility.

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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$95.50$75.86 to $186
FacilityA hospital or hospital-owned outpatient department$214$105 to $372

How much rates vary

Facilitymedian $214 · 10th to 90th $62 to $832Professionalmedian $95 · 10th to 90th $72 to $1,175
$100$200$500$1Kfacility $214professional $95

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$95.50
Median
$95.50
Typical High
$95.50
BCBS Arizona
Setting
Facility
Modifier
None
Typical Low
$56.23
Median
$257.04
Typical High
$389.05
BCBS Arizona
Setting
Professional
Modifier
None
Typical Low
$165.96
Median
$186.21
Typical High
$338.84
Cigna
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Cigna
Setting
Professional
Modifier
None
Typical Low
$72.44
Median
$72.44
Typical High
$100.00
Medica
Setting
Facility
Modifier
None
Typical Low
$95.50
Median
$213.80
Typical High
$831.76
Medica
Setting
Professional
Modifier
None
Typical Low
$74.13
Median
$114.82
Typical High
$1,174.90
United
Setting
Facility
Modifier
None
Typical Low
$102.33
Median
$102.33
Typical High
$107.15
United
Setting
Professional
Modifier
None
Typical Low
$72.44
Median
$79.43
Typical High
$120.23
4 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$47.86
Median
$47.86
Typical High
$47.86
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$19.05
Median
$19.05
Typical High
$19.05
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$14.45
Median
$14.45
Typical High
$14.45
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$9.55
Median
$9.55
Typical High
$9.55

Where Arizona sits

The same service costs 4.1 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.

Arizona· 33rd of 51

$100

HI $295DE $72.44

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.