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Alaska rates for HCPCS L5697

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

Facilitymedian $60 · 10th–90th $31–$1410%20%40%10th90th$60Professionalmedian $78 · 10th–90th $52–$2000%10%10th90th$78$50.0$100.0$200.0$500.0

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
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $70.79 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $43.65 / $169.82
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $97.72 / $141.25
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $141.25 / $389.05
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $141.25 / $147.91
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $141.25 / $147.91
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $30.90 / $131.83
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $60.26 / $123.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $72.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $72.44 / $234.42