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New Jersey rates for HCPCS L5697

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

Facilitymedian $55 · 10th–90th $35–$980%20%40%10th90th$55Professionalmedian $54 · 10th–90th $37–$950%10%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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $34.67
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $50.12 / $83.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $60.26 / $97.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $43.65 / $60.26
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $91.20 / $131.83
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $95.50
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
$43.65 / $57.54 / $93.33