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Pelvic Joint, Above-Knee or Knee Disarticulation

Michigan rates for HCPCS L5696

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

Rates data updated July 2026.

Facilitymedian $302 · 10th–90th $135$9550%20%10th90th$302Professionalmedian $135 · 10th–90th $112$2400%20%10th90th$135$0.2$1.0$5.0$20.0$100.0$500.0$2.0K

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
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$134.90
Typical High
$158.49
BCBS
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$707.95
Typical High
$1,348.96
BCBS
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$234.42
Typical High
$245.47
CareSource
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$138.04
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$138.04
Typical High
$275.42
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$446.68
Typical High
$501.19
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$190.55
Typical High
$288.40
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$194.98
Typical High
$275.42
United
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$194.98
Typical High
$302.00
United
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$112.20
Typical High
$169.82