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Idaho rates for HCPCS L5696

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

Facilitymedian $257 · 10th–90th $138–$3550%20%10th90th$257Professionalmedian $191 · 10th–90th $102–$3310%10%10th90th$191$50.0$100.0$200.0$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
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $181.97 / $245.47
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $281.84 / $478.63
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $331.13 / $331.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $138.04
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $229.09 / $302.00
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $288.40 / $302.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $257.04
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $288.40 / $288.40
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $316.23
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $302.00 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $165.96 / $169.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $109.65 / $169.82