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
Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.
| Hospital | Medicare Advantage rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $128 – $141 | — | — |
| Deaconess Medical Center | $128 – $141 | — | — |
| Harborview Medical Center | $131 – $144 | $161 | $229 |
| Kadlec Regional Medical Center | $131 – $157 | — | — |
| Mary Bridge Children's Hospital | $128 – $141 | — | — |
| MultiCare Auburn Medical Center | $128 – $141 | — | — |
| MultiCare Covington Medical Center | $128 – $141 | — | — |
| MultiCare Good Samaritan Hospital | $128 – $141 | — | — |
| MultiCare Valley Hospital | $132 – $141 | — | — |
| Overlake Hospital Medical Center & Clinics | $131 – $136 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $131 – $157 | — | — |
| Providence Centralia Hospital | $131 – $210 | — | — |
| Providence Regional Medical Center Everett | $131 – $144 | — | — |
| Providence St Peter Hospital | $131 – $210 | — | — |
| Seattle Children's Hospital | — | $383 | $383 |
| Swedish Edmonds Hospital | $131 – $157 | — | — |
| Swedish Issaquah | $131 – $157 | — | — |
| Swedish Medical Center | $131 – $157 | — | — |
| Swedish Medical Center / Cherry Hill | $131 – $157 | — | — |
| Tacoma General Allenmore Hospital | $128 – $141 | — | — |
| University of Washington Medical Ctr | $131 – $144 | $204 | $291 |
| Virginia Mason Medical Center | $89.93 – $135 | — | — |
| Wellfound Behavioral Health Hospital | — | — | — |
| Yakima Valley Memorial | $128 – $144 | — | — |
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)