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Illinois rates for HCPCS L5697

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

Facilitymedian $126 · 10th–90th $55–$5750%20%10th90th$126Professionalmedian $56 · 10th–90th $41–$1150%20%10th90th$56$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
$54.95 / $54.95 / $114.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $54.95 / $107.15
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $218.78 / $776.25
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $43.65 / $114.82
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $117.49 / $151.36
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $85.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $91.20 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $56.23 / $93.33