go back

California rates for HCPCS L5697

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

Facilitymedian $56 · 10th–90th $44$2510%20%10th90th$56Professionalmedian $58 · 10th–90th $42$4900%20%10th90th$58$0.1$0.5$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $562.34
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $57.54 / $489.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $56.23 / $251.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $154.88
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $190.55 / $302.00
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $239.88 / $478.63
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $43.65 / $60.26
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $57.54 / $158.49
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $117.49 / $213.80
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $724.44 / $724.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $95.50
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $107.15 / $158.49
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $43.65 / $125.89
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $239.88
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $60.26 / $117.49
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.94 / $64.57 / $131.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $57.54 / $134.90