Prosthetic addition for above-knee leg device, pelvic joint

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

Ak/knee disartic pelvic join

Payers reporting HCPCS L5696

Payer pricing summary

Low

$78

Average

$311

Median

$285

High

$692

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +12 other terms	359	$253	$300	$173	58%	—	$109 – $2.0k
2	UnitedHealthcare fee schedule · outpatient · +13 other terms	356	$246	$250	$77	31%	—	$111 – $1.0k
3	Humana fee schedule · outpatient · +12 other terms	317	$241	$384	$443	115%	—	$126 – $2.1k
4	Blue Cross Blue Shield fee schedule · outpatient · +10 other terms	218	$266	$341	$189	55%	—	$0 – $1.3k
5	WellCare fee schedule · outpatient · +4 other terms	208	$266	$274	$44	16%	—	$222 – $480
6	Devoted fee schedule · outpatient · +3 other terms	165	$227	$257	$23	9%	—	$218 – $308
7	Molina fee schedule · outpatient · +5 other terms	138	$377	$372	$142	38%	—	$135 – $712
8	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$242	$262	$17	7%	—	$227 – $311
9	Cigna fee schedule · outpatient · +9 other terms	102	$247	$287	$92	32%	—	$218 – $706
10	Anthem fee schedule · outpatient · +6 other terms	80	$227	$330	$320	97%	—	$127 – $1.8k
11	Kaiser fee schedule · outpatient · +6 other terms	64	$231	$458	$371	81%	—	$218 – $2.2k
12	Ambetter facility · fee schedule · outpatient · +6 other terms	47	$429	$436	$87	20%	—	$175 – $612
13	Superior Healthplan fee schedule · outpatient	40	$285	$285	$1	0%	—	$266 – $285
14	Clover fee schedule · outpatient · +2 other terms	37	$241	$250	$21	8%	—	$227 – $302
15	Oscar fee schedule · outpatient · +4 other terms	36	$266	$302	$86	29%	—	$238 – $513
16	Optum fee schedule · outpatient · +2 other terms	33	$227	$329	$160	49%	—	$218 – $679
17	Caresource fee schedule · outpatient · +5 other terms	28	$227	$249	$74	30%	—	$127 – $373
18	Medica facility · fee schedule · outpatient · +5 other terms	22	$247	$225	$59	26%	—	$80 – $403
19	Regence facility · fee schedule · outpatient · +4 other terms	19	$236	$248	$19	8%	—	$227 – $289
20	Amerihealth Caritas fee schedule · outpatient · +1 other terms	18	$272	$268	$6	2%	—	$258 – $272
21	Bcbs Tx fee schedule · outpatient	18	$266	$266	—	—	—	$266 – $266
22	Medicare fee schedule · outpatient · +3 other terms	18	$218	$218	$2	1%	—	$218 – $222
23	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$241	$279	$69	25%	—	$131 – $381
24	Tricare facility · fee schedule · outpatient · +2 other terms	15	$250	$244	$13	6%	—	$221 – $255
25	Bcbs Mn fee schedule · outpatient · +6 other terms	13	$219	$219	$51	23%	—	$107 – $257

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