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Maryland rates for HCPCS L5696

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

Facilitymedian $166 · 10th–90th $138–$1700%20%40%10th90th$166Professionalmedian $132 · 10th–90th $102–$2000%20%10th90th$132$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
$104.71 / $131.83 / $199.53
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $173.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $138.04
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $257.04 / $380.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $165.96 / $169.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $131.83 / $199.53
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $218.78