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Pelvic Joint, Above-Knee or Knee Disarticulation

South Dakota rates for HCPCS L5696

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

Rates data updated July 2026.

Facilitymedian $224 · 10th–90th $162$4370%10%10th90th$224Professionalmedian $219 · 10th–90th $186$3390%20%10th90th$219$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$199.53
Typical High
$251.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$263.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$338.84
Medica
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$223.87
Typical High
$588.84
Medica
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$169.82
Typical High
$1,479.11
Midlands
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$257.04
Typical High
$263.03
Midlands
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$263.03
Typical High
$263.03
Midlands
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$398.11
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$223.87
Typical High
$295.12
United
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$165.96
Typical High
$186.21
United
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$169.82
Typical High
$275.42
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$234.42