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Pennsylvania rates for HCPCS L5614

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

Facilitymedian $2,455 · 10th–90th $891–$3,4670%20%10th90th$2,455Professionalmedian $1,000 · 10th–90th $871–$1,7380%20%40%10th90th$1,000$1.0$10.0$100.0$1.0K$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $3,467.37 / $3,467.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,000.00 / $1,698.24
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,621.81 / $2,041.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $2,041.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $1,318.26
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,630.27 / $3,890.45
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,041.74 / $2,041.74
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,412.54 / $2,041.74
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $891.25
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,000.00 / $1,698.24
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $2,818.38 / $3,890.45
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,949.84 / $1,949.84
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,949.84 / $1,949.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $2,454.71 / $2,818.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,122.02 / $2,041.74