go back

Michigan rates for HCPCS L5697

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

Facilitymedian $132 · 10th–90th $63–$4570%20%10th90th$132Professionalmedian $60 · 10th–90th $41–$1120%20%10th90th$60$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
$64.57 / $64.57 / $64.57
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $54.95 / $83.18
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $338.84 / $645.65
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $117.49
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $63.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $60.26 / $120.23
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $213.80 / $239.88
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $89.13 / $138.04
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $72.44 / $107.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $91.20 / $131.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $52.48 / $75.86