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Arizona rates for HCPCS L5697

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

Facilitymedian $105 · 10th–90th $31–$2510%10%10th90th$105Professionalmedian $56 · 10th–90th $41–$1070%20%10th90th$56$0.1$0.5$2.0$10.0$50.0$200.0

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
$40.74 / $56.23 / $93.33
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $128.82 / $239.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $117.49 / $223.87
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 / $60.26
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $85.11 / $512.86
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $47.86 / $645.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $74.13 / $104.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $47.86 / $74.13