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Maryland rates for HCPCS L5697

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

Facilitymedian $72 · 10th–90th $60–$740%20%40%10th90th$72Professionalmedian $54 · 10th–90th $42–$850%20%10th90th$54$50.0$100.0$200.0$500.0

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
$41.69 / $53.70 / $85.11
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $70.79
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $63.10
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $43.65 / $60.26
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $102.33 / $154.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $72.44 / $74.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $53.70 / $79.43
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $87.10