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Prosthetic Knee, Exoskeletal Four-Bar, Pneumatic Swing

Maine 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 $2,089 · 10th–90th $1,318$2,5120%20%10th90th$2,089Professionalmedian $1,318 · 10th–90th $912$1,7380%20%10th90th$1,318$1.0K$2.0K$5.0K$10.0K

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
$870.96
Median
$1,096.48
Typical High
$1,348.96
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,949.84
Median
$2,344.23
Typical High
$2,691.53
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,122.02
Median
$1,122.02
Typical High
$2,041.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,318.26
Median
$1,318.26
Typical High
$1,445.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$954.99
Typical High
$1,318.26
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$1,737.80
Median
$1,737.80
Typical High
$2,089.30
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,122.02
Typical High
$1,348.96
United
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$1,202.26
Typical High
$1,445.44
United
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$1,737.80
Typical High
$1,737.80