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Indiana rates for HCPCS L5696

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

Facilitymedian $240 · 10th–90th $112–$2750%20%40%10th90th$240Professionalmedian $123 · 10th–90th $105–$1950%20%40%10th90th$123$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
$112.20 / $112.20 / $112.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $120.23 / $186.21
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $239.88 / $302.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $239.88
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $288.40 / $331.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $208.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $169.82 / $194.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $117.49 / $173.78