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Hawaii rates for HCPCS L5697

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

Facilitymedian $63 · 10th–90th $60–$1230%20%10th90th$63Professionalmedian $76 · 10th–90th $41–$1580%10%20%10th90th$76$50.0$100.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $56.23 / $85.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $123.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $144.54 / $194.98
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $165.96
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $158.49 / $181.97
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $64.57 / $75.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $74.13 / $169.82