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Nebraska rates for HCPCS L5697

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

Facilitymedian $105 · 10th–90th $62–$5130%10%20%10th90th$105Professionalmedian $62 · 10th–90th $35–$2570%10%20%10th90th$62$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
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $61.66
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $61.66 / $562.34
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $93.33 / $93.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $128.82 / $186.21
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $109.65 / $512.86
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $60.26 / $100.00
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $107.15 / $257.04
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $239.88 / $257.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $72.44 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $47.86 / $75.86