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Pelvic Joint, Above-Knee or Knee Disarticulation

Ohio rates for HCPCS L5696

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

Rates data updated July 2026.

Facilitymedian $251 · 10th–90th $115$4070%20%10th90th$251Professionalmedian $129 · 10th–90th $102$2510%20%40%10th90th$129$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
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$199.53
Aetna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$114.82
Typical High
$199.53
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$257.04
Typical High
$512.86
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$144.54
Typical High
$316.23
CareSource
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$190.55
Typical High
$269.15
CareSource
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$199.53
Typical High
$302.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$151.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$154.88
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$144.54
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$138.04
Molina
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$144.54
Typical High
$208.93
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$269.15
Typical High
$501.19
United
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$194.98
Typical High
$257.04
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$117.49
Typical High
$169.82