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Prosthetic Knee, Exoskeletal Four-Bar, Pneumatic Swing

California rates for HCPCS L5614

Addition to lower extremity, exoskeletal system, above knee (AK), knee disarticulation, four-bar linkage, with pneumatic swing phase control

Rates data updated July 2026.

Facilitymedian $1,047 · 10th–90th $832$4,7860%20%10th90th$1,047Professionalmedian $1,096 · 10th–90th $871$8,7100%20%10th90th$1,096$2.0$10.0$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$1,096.48
Typical High
$8,709.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,096.48
Typical High
$8,709.64
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$1,047.13
Typical High
$4,466.84
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,096.48
Median
$1,122.02
Typical High
$2,454.71
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$3,162.28
Typical High
$4,897.79
Blue Shield
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$1,905.46
Typical High
$5,128.61
Cigna
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$1,318.26
Typical High
$1,318.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$954.99
Typical High
$1,318.26
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,288.25
Typical High
$2,454.71
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$1,230.27
Median
$1,819.70
Typical High
$3,162.28
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$9,772.37
Median
$9,772.37
Typical High
$9,772.37
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$14,791.08
Median
$14,791.08
Typical High
$15,135.61
Molina
Setting
Professional
Modifier
Global
Typical Low
$2,041.74
Median
$2,041.74
Typical High
$2,041.74
Optum
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$70.79
Providence
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$1,819.70
Typical High
$2,630.27
Providence
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$954.99
Typical High
$1,949.84
Sutter Health Plus
Setting
Professional
Modifier
Global
Typical Low
$3,715.35
Median
$3,715.35
Typical High
$3,715.35
The Alliance
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,380.38
Typical High
$1,819.70
United
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$1,202.26
Typical High
$2,454.71
United
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,096.48
Typical High
$2,089.30