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.
Original text from hospital filings
Ak pelvic control belt pad/l
Peoria, IL
See all hospitals reporting HCPCS L5694 →Price type
Proctor Community Hospital’s median price of $222 is 10% below the median hospital's median price ($246), higher than 18% of the 840 hospitals reporting HCPCS L5694. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 11 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
Filter by billing methodology
Filter by billing class
| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Aetna Better Health medicare-medicaid (d-snp) fee schedule · inpatient | $120 | $120 | — | — | — | $120 – $120 |
| 2 | Aetna Better Health medicare-medicaid (d-snp) fee schedule · outpatient | $120 | $120 | — | — | — | $120 – $120 |
| 3 | Aetna medicare advantage case rate · outpatient | $222 | $222 | — | — | — | $222 – $222 |
| 4 | Blue Cross Blue Shield medicare advantage case rate · outpatient | $222 | $222 | — | — | — | $222 – $222 |
| 5 | Humana medicare advantage case rate · outpatient | $222 | $222 | — | — | — | $222 – $222 |
| 6 | Humana medicare-medicaid (d-snp) fee schedule · outpatient | $222 | $222 | — | — | — | $222 – $222 |
| 7 | Molina medicare-medicaid (mmai/dual) case rate · outpatient | $222 | $222 | — | — | — | $222 – $222 |
| 8 | UnitedHealthcare medicare advantage case rate · outpatient | $222 | $222 | — | — | — | $222 – $222 |
| 9 | UnitedHealthcare va ccn case rate · outpatient | $222 | $222 | — | — | — | $222 – $222 |
| 10 | WellCare medicare advantage hmo case rate · outpatient | $222 | $222 | — | — | — | $222 – $222 |
| 11 | UnitedHealthcare ppo fee schedule · outpatient | $255 | $255 | — | — | — | $255 – $255 |
Last updated: Apr 15, 2026
See Pelvic control belt for above-knee prosthesis pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.