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Pelvic Joint, Above-Knee or Knee Disarticulation

Montana rates for HCPCS L5696

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

Rates data updated July 2026.

Facilitymedian $219 · 10th–90th $158$3090%20%40%10th90th$219Professionalmedian $186 · 10th–90th $71$4270%10%10th90th$186$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
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$186.21
Typical High
$1,288.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$234.42
Typical High
$234.42
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$234.42
Typical High
$234.42
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$218.78
Typical High
$426.58
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$218.78
Typical High
$426.58
Providence
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$223.87
Typical High
$316.23
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$173.78
Typical High
$281.84
United
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$165.96
Typical High
$173.78
United
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$109.65
Typical High
$169.82