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Pelvic Joint, Above-Knee or Knee Disarticulation

Washington rates for HCPCS L5696

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

Rates data updated July 2026.

Facilitymedian $288 · 10th–90th $191$5750%20%10th90th$288Professionalmedian $245 · 10th–90th $110$4470%10%10th90th$245$2.0$10.0$50.0$200.0$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
$190.55
Median
$190.55
Typical High
$457.09
Aetna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$190.55
Typical High
$1,288.25
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$288.40
Typical High
$295.12
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$331.13
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
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$331.13
Typical High
$851.14
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$323.59
Typical High
$512.86
Molina
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$229.09
Typical High
$251.19
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$288.40
Typical High
$295.12
Pacific Source
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$295.12
Typical High
$323.59
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$436.52
Typical High
$588.84
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$245.47
Typical High
$288.40
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$295.12
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$257.04
Typical High
$331.13
United
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$302.00
Typical High
$363.08
United
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$158.49
Typical High
$218.78
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$257.04
Typical High
$457.09