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Prosthetic Knee, Exoskeletal Four-Bar, Pneumatic Swing

New Hampshire 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 $2,042 · 10th–90th $1,122$2,4550%20%40%10th90th$2,042Professionalmedian $1,349 · 10th–90th $891$1,7380%20%10th90th$1,349$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,122.02
Median
$1,122.02
Typical High
$1,348.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,122.02
Typical High
$1,348.96
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$2,187.76
Typical High
$2,454.71
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,122.02
Median
$1,122.02
Typical High
$1,122.02
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
$3,235.94
United
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$1,288.25
Typical High
$1,445.44
United
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,380.38
Typical High
$1,737.80
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$1,905.46
Median
$1,905.46
Typical High
$2,818.38