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Nebraska rates for HCPCS L5696

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

Facilitymedian $251 · 10th–90th $148–$1,1750%20%10th90th$251Professionalmedian $151 · 10th–90th $85–$6310%10%20%10th90th$151$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $151.36 / $1,288.25
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $229.09 / $229.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $263.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $275.42 / $426.58
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $263.03 / $1,174.90
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $147.91 / $234.42
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $263.03 / $630.96
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $263.03
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $588.84 / $630.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $165.96 / $257.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $117.49 / $186.21