go back

Prosthetic Knee, Exoskeletal Four-Bar, Pneumatic Swing

Hawaii 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 $1,318 · 10th–90th $1,202$1,6980%20%40%10th90th$1,318Professionalmedian $2,188 · 10th–90th $724$2,2910%50%10th90th$2,188$1.0K$2.0K

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

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$724.44
Typical High
$1,000.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,318.26
Median
$1,318.26
Typical High
$1,698.24
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,318.26
Median
$1,995.26
Typical High
$2,691.53
HMSA
Setting
Professional
Modifier
Global
Typical Low
$2,187.76
Median
$2,187.76
Typical High
$2,290.87
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$1,318.26
Median
$2,187.76
Typical High
$3,090.30
United
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$1,230.27
Typical High
$1,445.44
United
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,513.56
Typical High
$2,691.53