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Pelvic Joint, Above-Knee or Knee Disarticulation

Iowa rates for HCPCS L5696

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

Rates data updated July 2026.

Facilitymedian $209 · 10th–90th $148$5890%20%10th90th$209Professionalmedian $166 · 10th–90th $95$2880%10%20%10th90th$166$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
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$186.21
Typical High
$199.53
Aetna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$151.36
Typical High
$223.87
Cigna
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$263.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$275.42
Typical High
$338.84
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$239.88
Typical High
$288.40
Medica
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$309.03
Typical High
$1,174.90
Medica
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$165.96
Typical High
$398.11
Midlands
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$275.42
Typical High
$346.74
Midlands
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$263.03
Typical High
$263.03
Midlands
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$398.11
Typical High
$398.11
United
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$186.21
Typical High
$478.63
United
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$134.90
Typical High
$234.42
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$234.42
Typical High
$234.42