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Indiana rates for HCPCS L5697

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

Facilitymedian $115 · 10th–90th $54–$1230%50%10th90th$115Professionalmedian $55 · 10th–90th $43–$870%50%10th90th$55$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
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $53.70 / $77.62
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $114.82 / $144.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $104.71
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $125.89 / $144.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $114.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $43.65 / $97.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $72.44 / $91.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $56.23 / $81.28