go back

Prosthetic Knee, Exoskeletal Four-Bar, Pneumatic Swing

South Dakota 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 $1,380$5,4950%5%10%10th90th$1,995Professionalmedian $1,995 · 10th–90th $1,514$2,9510%20%10th90th$1,995$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,513.56
Median
$1,513.56
Typical High
$1,513.56
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,584.89
Median
$1,698.24
Typical High
$1,995.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,318.26
Median
$1,318.26
Typical High
$2,290.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2,344.23
Median
$2,344.23
Typical High
$2,951.21
Medica
Setting
Facility
Modifier
Global
Typical Low
$1,621.81
Median
$2,089.30
Typical High
$5,623.41
Medica
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,380.38
Typical High
$14,454.40
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,862.09
Median
$2,238.72
Typical High
$2,238.72
Midlands
Setting
Facility
Modifier
Global
Typical Low
$2,290.87
Median
$2,290.87
Typical High
$2,290.87
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,862.09
Median
$1,862.09
Typical High
$3,715.35
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$1,698.24
Median
$2,041.74
Typical High
$2,754.23
United
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$1,380.38
Typical High
$1,513.56
United
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$1,380.38
Typical High
$2,398.83
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$2,041.74
Median
$2,041.74
Typical High
$2,041.74