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Minnesota rates for HCPCS L5697

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

Facilitymedian $123 · 10th–90th $93–$8130%20%10th90th$123Professionalmedian $112 · 10th–90th $54–$1290%20%40%10th90th$112$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
$93.33 / $93.33 / $93.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $70.79 / $93.33
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $112.20 / $144.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $112.20 / $112.20
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $426.58 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $147.91 / $165.96
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $416.87 / $812.83
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $177.83
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $112.20 / $512.86
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $47.86 / $134.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.78 / $64.57 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $60.26 / $154.88