Prosthetic knee joint add-on, polycentric, pair

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Bk knee joints polycentric p

Payers reporting HCPCS L5677

Payer pricing summary

Low

$209

Average

$798

Median

$741

High

$1.8k

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +12 other terms	361	$679	$786	$421	54%	—	$289 – $5.6k
2	UnitedHealthcare fee schedule · outpatient · +13 other terms	358	$626	$659	$190	29%	—	$126 – $2.2k
3	Humana fee schedule · outpatient · +13 other terms	319	$627	$1.1k	$1.3k	122%	—	$345 – $6.2k
4	Blue Cross Blue Shield fee schedule · outpatient · +11 other terms	219	$789	$925	$507	55%	—	$0 – $3.9k
5	WellCare fee schedule · outpatient · +5 other terms	208	$680	$773	$121	16%	—	$592 – $1.2k
6	Devoted fee schedule · outpatient · +4 other terms	165	$604	$736	$98	13%	—	$580 – $861
7	Molina fee schedule · outpatient · +5 other terms	140	$968	$1.0k	$432	42%	—	$126 – $2.1k
8	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$646	$745	$85	11%	—	$604 – $828
9	Cigna fee schedule · outpatient · +11 other terms	102	$660	$742	$220	30%	—	$580 – $2.0k
10	Anthem fee schedule · outpatient · +6 other terms	80	$604	$891	$912	102%	—	$345 – $5.1k
11	Kaiser fee schedule · outpatient · +6 other terms	64	$616	$1.1k	$793	73%	—	$580 – $4.8k
12	Ambetter facility · fee schedule · outpatient · +6 other terms	46	$1.1k	$1.2k	$236	20%	—	$592 – $1.7k
13	Superior Healthplan fee schedule · outpatient	40	$845	$845	$4	0%	—	$789 – $845
14	Clover fee schedule · outpatient · +3 other terms	37	$604	$660	$99	15%	—	$592 – $845
15	Oscar fee schedule · outpatient · +4 other terms	36	$789	$846	$226	27%	—	$634 – $1.4k
16	Optum fee schedule · outpatient · +3 other terms	33	$604	$924	$506	55%	—	$580 – $2.0k
17	Caresource fee schedule · outpatient · +5 other terms	28	$604	$678	$217	32%	—	$345 – $1.1k
18	Medica facility · fee schedule · outpatient · +5 other terms	22	$695	$631	$163	26%	—	$226 – $1.1k
19	Amerihealth Caritas fee schedule · outpatient · +1 other terms	18	$724	$706	$35	5%	—	$616 – $724
20	Bcbs Tx fee schedule · outpatient	18	$789	$789	—	—	—	$789 – $789
21	Medicare fee schedule · outpatient · +3 other terms	18	$580	$582	$5	1%	—	$580 – $592
22	Regence facility · fee schedule · outpatient · +6 other terms	17	$628	$622	$24	4%	—	$548 – $640
23	Tricare facility · fee schedule · outpatient · +2 other terms	16	$604	$596	$15	2%	—	$543 – $604
24	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$679	$783	$194	25%	—	$370 – $1.1k
25	Highmark facility · fee schedule · outpatient · +4 other terms	14	$1.1k	$1.0k	$432	41%	—	$580 – $1.7k

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