go back

Ohio rates for HCPCS L5697

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

Facilitymedian $120 · 10th–90th $60$2000%20%40%10th90th$120Professionalmedian $56 · 10th–90th $42$1020%20%10th90th$56$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
$53.70 / $53.70 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $53.70 / $83.18
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $120.23 / $245.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $67.61 / $147.91
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $95.50
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $81.28 / $114.82
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $87.10 / $128.82
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
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $43.65 / $60.26
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $69.18 / $97.72
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $138.04
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $128.82 / $234.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $79.43 / $114.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $54.95 / $74.13