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Prosthetic Knee, Exoskeletal Four-Bar, Pneumatic Swing

Massachusetts 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 $2,512 · 10th–90th $1,072$5,0120%20%10th90th$2,512Professionalmedian $1,738 · 10th–90th $871$2,6300%20%40%10th90th$1,738$2.0$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$870.96
Median
$870.96
Typical High
$870.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$977.24
Typical High
$2,754.23
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$1,905.46
Median
$3,019.95
Typical High
$9,772.37
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,659.59
Typical High
$2,884.03
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,238.72
Median
$2,691.53
Typical High
$3,467.37
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,318.26
Median
$1,380.38
Typical High
$3,019.95
Cigna
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$954.99
Typical High
$2,344.23
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$3,630.78
Typical High
$9,772.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$1,737.80
Median
$1,737.80
Typical High
$2,630.27
Health New England
Setting
Professional
Modifier
Global
Typical Low
$1,698.24
Median
$1,698.24
Typical High
$1,698.24
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$1,905.46
Median
$3,019.95
Typical High
$9,772.37
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,659.59
Typical High
$2,884.03
United
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$1,412.54
Typical High
$2,454.71
United
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,659.59
Typical High
$1,778.28