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Prosthetic Knee, Exoskeletal Four-Bar, Pneumatic Swing

Michigan 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 $2,455 · 10th–90th $1,175$8,3180%10%20%10th90th$2,455Professionalmedian $1,175 · 10th–90th $977$2,0420%20%10th90th$1,175$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
$1,174.90
Median
$1,174.90
Typical High
$1,174.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,096.48
Typical High
$1,174.90
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,691.53
Median
$6,165.95
Typical High
$11,748.98
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,949.84
Median
$2,041.74
Typical High
$2,137.96
CareSource
Setting
Facility
Modifier
Global
Typical Low
$1,318.26
Median
$1,318.26
Typical High
$1,318.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,318.26
Median
$1,318.26
Typical High
$1,318.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$1,348.96
Typical High
$2,041.74
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$3,890.45
Typical High
$4,365.16
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,621.81
Typical High
$2,511.89
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$1,348.96
Median
$1,348.96
Typical High
$2,041.74
United
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$1,659.59
Typical High
$2,454.71
United
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$977.24
Typical High
$1,445.44