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Missouri rates for HCPCS L5697

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

Facilitymedian $79 · 10th–90th $47–$2140%20%10th90th$79Professionalmedian $58 · 10th–90th $41–$930%20%10th90th$58$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
$43.65 / $64.57 / $64.57
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $54.95 / $93.33
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $346.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $57.54 / $91.20
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $97.72
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
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $77.62 / $229.09
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $50.12 / $645.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $79.43 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $47.86 / $74.13