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Iowa rates for HCPCS L5696

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

Facilitymedian $234 · 10th–90th $155–$6310%20%10th90th$234Professionalmedian $135 · 10th–90th $95–$2450%10%20%10th90th$135$0.2$1.0$5.0$20.0$100.0$500.0

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
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $186.21 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $128.82 / $194.98
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $263.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $275.42 / $338.84
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $239.88 / $288.40
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $309.03 / $1,174.90
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $165.96 / $398.11
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $269.15 / $338.84
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $263.03
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $398.11 / $398.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $239.88 / $588.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $128.82 / $223.87
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $234.42 / $234.42