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Pelvic Joint, Above-Knee or Knee Disarticulation

Pennsylvania rates for HCPCS L5696

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

Rates data updated July 2026.

Facilitymedian $295 · 10th–90th $112$6460%20%10th90th$295Professionalmedian $123 · 10th–90th $95$2040%20%40%10th90th$123$0.2$2.0$20.0$200.0$2.0K$20.0K

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
$112.20
Median
$112.20
Typical High
$426.58
Aetna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$123.03
Typical High
$190.55
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$251.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$346.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$138.04
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$323.59
Typical High
$467.74
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$257.04
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$173.78
Typical High
$257.04
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$426.58
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$123.03
Typical High
$199.53
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$537.03
Typical High
$977.24
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$223.87
Typical High
$239.88
United
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$302.00
Typical High
$302.00
United
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$141.25
Typical High
$245.47