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Missouri rates for HCPCS L5614

Addition to lower extremity, exoskeletal system, above knee (AK), knee disarticulation, four-bar linkage, with pneumatic swing phase control

Facilitymedian $1,660 · 10th–90th $1,000–$4,1690%20%10th90th$1,660Professionalmedian $1,122 · 10th–90th $871–$1,9500%20%10th90th$1,122$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $1,380.38 / $1,380.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,071.52 / $1,949.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $7,244.36
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,122.02 / $1,905.46
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $2,089.30
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $1,380.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $1,318.26
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,621.81 / $4,570.88
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,023.29 / $14,454.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,659.59 / $1,659.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,000.00 / $1,479.11