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Alaska rates for HCPCS L5696

Addition to lower extremity, above knee (AK) or knee disarticulation, pelvic joint

Facilitymedian $138 · 10th–90th $71–$3240%20%40%10th90th$138Professionalmedian $182 · 10th–90th $112–$4570%10%10th90th$182$100.0$200.0$500.0$1.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $165.96 / $295.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $138.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $389.05
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $218.78 / $323.59
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $323.59 / $912.01
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $323.59 / $338.84
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $323.59 / $338.84
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $302.00
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $138.04 / $281.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $165.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $165.96 / $537.03