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Pennsylvania rates for HCPCS L5696

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

Facilitymedian $257 · 10th–90th $112–$4270%20%10th90th$257Professionalmedian $123 · 10th–90th $95–$2090%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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $426.58 / $426.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $123.03 / $194.98
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $138.04
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $323.59 / $467.74
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $173.78 / $257.04
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $123.03 / $190.55
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $331.13 / $478.63
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $239.88
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $239.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $302.00 / $346.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $141.25 / $245.47