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Idaho rates for HCPCS L5697

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

Facilitymedian $112 · 10th–90th $60–$1580%10%20%10th90th$112Professionalmedian $83 · 10th–90th $44–$1450%5%10%10th90th$83$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $77.62 / $107.15
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $123.03 / $208.93
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $144.54 / $144.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $81.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $43.65 / $60.26
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $97.72 / $131.83
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $125.89 / $131.83
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $112.20
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $125.89 / $125.89
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $138.04
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $131.83 / $131.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $72.44 / $74.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $47.86 / $74.13