go back

South Carolina rates for HCPCS L5696

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

Facilitymedian $158 · 10th–90th $100–$3160%10%20%10th90th$158Professionalmedian $123 · 10th–90th $95–$1910%10%20%10th90th$123$50.0$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
$100.00 / $100.00 / $100.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $123.03 / $190.55
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $223.87 / $263.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $138.04 / $154.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $275.42
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $151.36
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $186.21 / $380.19
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $72.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $151.36
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $165.96 / $302.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $109.65 / $165.96