HCPCS L5697
Addition to lower extremity, above knee or knee disarticulation, pelvic band
Current code24 hospitals with prices
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $113 – $876 | — | — |
| Deaconess Medical Center | $157 – $545 | — | — |
| Harborview Medical Center | $210 – $262 | $161 | $229 |
| Kadlec Regional Medical Center | $198 – $368 | — | — |
| Mary Bridge Children's Hospital | $113 – $962 | — | — |
| MultiCare Auburn Medical Center | $110 – $566 | — | — |
| MultiCare Covington Medical Center | $110 – $566 | — | — |
| MultiCare Good Samaritan Hospital | $127 – $566 | — | — |
| MultiCare Valley Hospital | $125 – $544 | — | — |
| Overlake Hospital Medical Center & Clinics | $120 – $361 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $203 – $435 | — | — |
| Providence Centralia Hospital | $221 – $490 | — | — |
| Providence Regional Medical Center Everett | $157 – $304 | — | — |
| Providence St Peter Hospital | $111 – $428 | — | — |
| Seattle Children's Hospital | $207 – $368 | $383 | $383 |
| Swedish Edmonds Hospital | $197 – $481 | — | — |
| Swedish Issaquah | $197 – $291 | — | — |
| Swedish Medical Center | $197 – $468 | — | — |
| Swedish Medical Center / Cherry Hill | $197 – $468 | — | — |
| Tacoma General Allenmore Hospital | $110 – $566 | — | — |
| University of Washington Medical Ctr | $210 – $411 | $204 | $291 |
| Virginia Mason Medical Center | $125 – $456 | — | — |
| Wellfound Behavioral Health Hospital | $331 | — | — |
| Yakima Valley Memorial | $113 – $340 | — | — |
Medicare (traditional) reference
Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.
- Equipment fee, Washington
- $131 (fee)