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Prosthetic Knee, Exoskeletal Four-Bar, Pneumatic Swing

Montana 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 $1,995 · 10th–90th $1,318$2,5120%20%40%10th90th$1,995Professionalmedian $1,660 · 10th–90th $589$3,8900%10%20%10th90th$1,660$100.0$200.0$500.0$1.0K$2.0K$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
$588.84
Median
$1,659.59
Typical High
$8,709.64
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,318.26
Median
$2,137.96
Typical High
$2,137.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,318.26
Median
$2,137.96
Typical High
$2,137.96
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$1,995.26
Typical High
$3,890.45
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$1,584.89
Median
$1,995.26
Typical High
$3,890.45
Providence
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$1,905.46
Typical High
$2,951.21
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$1,621.81
Typical High
$2,187.76
United
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$1,380.38
Typical High
$1,445.44
United
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$912.01
Typical High
$1,412.54