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
Bk knee joints polycentric p
Cedar Rapids, IA
See all hospitals reporting HCPCS L5677 →Price type
St Luke's Methodist Hospital’s median price of $668 is 2% below the median hospital's median price ($679), higher than 49% of the 834 hospitals reporting HCPCS L5677. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 17 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.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare hmo fee schedule · both | $318 | $318 | — | — | — | $318 – $318 |
| 2 | UnitedHealthcare ppo fee schedule · both | $318 | $318 | — | — | — | $318 – $318 |
| 3 | Wellmark commercial fee schedule · both | $624 | $624 | — | — | — | $624 – $624 |
| 4 | Wellmark hmo fee schedule · both | $624 | $624 | — | — | — | $624 – $624 |
| 5 | Wellmark ppo fee schedule · both | $624 | $624 | — | — | — | $624 – $624 |
| 6 | Aetna medicare advantage case rate · outpatient | $649 | $649 | — | — | — | $649 – $649 |
| 7 | Molina medicare advantage case rate · outpatient | $649 | $649 | — | — | — | $649 – $649 |
| 8 | Wellmark medicare advantage case rate · outpatient | $649 | $649 | — | — | — | $649 – $649 |
| 9 | Humana medicare advantage case rate · outpatient | $668 | $668 | — | — | — | $668 – $668 |
| 10 | UnitedHealthcare medicare advantage case rate · outpatient | $668 | $668 | — | — | — | $668 – $668 |
| 11 | Aetna hmo fee schedule · both | $712 | $712 | — | — | — | $712 – $712 |
| 12 | Aetna ppo fee schedule · both | $712 | $712 | — | — | — | $712 – $712 |
| 13 | Cigna commercial fee schedule · both | $808 | $808 | — | — | — | $808 – $808 |
| 14 | UnitedHealthcare hmo fee schedule · outpatient | $947 | $947 | — | — | — | $947 – $947 |
| 15 | UnitedHealthcare ppo fee schedule · outpatient | $947 | $947 | — | — | — | $947 – $947 |
| 16 | Aetna hmo fee schedule · outpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 17 | Aetna ppo fee schedule · outpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
Last updated: Jan 28, 2026
See Prosthetic knee joint add-on, polycentric, pair pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.