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Ohio rates for HCPCS L5614

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

Facilitymedian $2,188 · 10th–90th $1,202–$3,6310%20%40%10th90th$2,188Professionalmedian $1,047 · 10th–90th $871–$1,7780%20%40%10th90th$1,047$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
$1,000.00 / $1,000.00 / $1,698.24
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,000.00 / $1,659.59
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,187.76 / $4,466.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,258.93 / $2,691.53
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,737.80 / $2,454.71
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,862.09 / $2,754.23
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
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $1,318.26
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $1,318.26
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,230.27 / $1,778.28
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,511.89 / $2,511.89
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,344.23 / $4,265.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $1,513.56 / $2,089.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $1,000.00 / $1,412.54