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Missouri rates for HCPCS L5696

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

Facilitymedian $195 · 10th–90th $110–$4790%20%10th90th$195Professionalmedian $135 · 10th–90th $102–$2340%20%10th90th$135$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
$107.15 / $158.49 / $158.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $123.03 / $234.42
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $851.14
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $134.90 / $223.87
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $239.88
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
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $190.55 / $524.81
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $125.89 / $1,479.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $194.98 / $194.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $117.49 / $173.78