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Prosthetic Knee, Exoskeletal Four-Bar, Pneumatic Swing

Idaho 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 $1,905 · 10th–90th $1,096$2,7540%20%40%10th90th$1,905Professionalmedian $1,514 · 10th–90th $912$2,2390%10%20%10th90th$1,514$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
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,288.25
Typical High
$1,659.59
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$1,905.46
Typical High
$3,311.31
BCBS
Setting
Professional
Modifier
Global
Typical Low
$2,137.96
Median
$2,238.72
Typical High
$2,238.72
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,258.93
Median
$1,318.26
Typical High
$1,380.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$954.99
Typical High
$1,318.26
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$1,659.59
Typical High
$2,187.76
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$1,659.59
Median
$1,905.46
Typical High
$2,041.74
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$1,698.24
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$1,905.46
Median
$1,949.84
Typical High
$1,949.84
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$1,412.54
Median
$1,412.54
Typical High
$2,238.72
Select Health
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$2,089.30
Typical High
$3,090.30
Select Health
Setting
Professional
Modifier
Global
Typical Low
$1,318.26
Median
$1,905.46
Typical High
$2,238.72
United
Setting
Facility
Modifier
Global
Typical Low
$1.45
Median
$1,380.38
Typical High
$1,445.44
United
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$912.01
Typical High
$1,412.54