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North Carolina rates for HCPCS L5696

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

Facilitymedian $170 · 10th–90th $100–$4790%20%10th90th$170Professionalmedian $166 · 10th–90th $100–$1860%20%40%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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $165.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $158.49 / $186.21
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $186.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $138.04 / $138.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $169.82
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $134.90 / $165.96
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $190.55 / $323.59
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $165.96 / $181.97
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $109.65 / $169.82
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $1,202.26
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,513.56 / $1,819.70