go back

Pelvic Joint, Above-Knee or Knee Disarticulation

North Carolina rates for HCPCS L5696

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

Rates data updated July 2026.

Facilitymedian $182 · 10th–90th $105$4370%20%10th90th$182Professionalmedian $166 · 10th–90th $100$1740%50%10th90th$166$0.2$2.0$20.0$200.0$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
$165.96
Median
$165.96
Typical High
$165.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$165.96
Typical High
$165.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$218.78
Typical High
$446.68
BCBS
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$186.21
Cigna
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$138.04
Typical High
$144.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$154.88
Medcost
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$134.90
Typical High
$165.96
Medcost
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$190.55
Typical High
$323.59
United
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$173.78
Typical High
$229.09
United
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$109.65
Typical High
$169.82
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$1,202.26
Typical High
$1,202.26
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$1,513.56
Median
$1,513.56
Typical High
$1,819.70