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Pelvic Joint, Above-Knee or Knee Disarticulation

Utah rates for HCPCS L5696

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

Rates data updated July 2026.

Facilitymedian $138 · 10th–90th $71$2240%20%40%10th90th$138Professionalmedian $138 · 10th–90th $71$1,2880%10%10th90th$138$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
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$117.49
Typical High
$1,288.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$138.04
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$138.04
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$162.18
Typical High
$208.93
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$223.87
Typical High
$223.87
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$158.49
Typical High
$331.13
Select Health
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$229.09
Typical High
$229.09
Select Health
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$229.09
Typical High
$302.00
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$229.09
Typical High
$338.84
United
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$147.91
Typical High
$173.78
United
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$109.65
Typical High
$169.82