go back

Illinois rates for HCPCS L5814

Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,219.06 / $2,219.06 / $2,219.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,954.17 / $2,219.06 / $3,678.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,356.71 / $9,062.61 / $38,576.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,407.42 / $3,407.42 / $3,407.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,502.67 / $2,502.67 / $4,907.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,826.95 / $2,502.67 / $5,197.50
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,810.93 / $5,155.97 / $6,276.83
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,828.49 / $5,828.49 / $5,828.49
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,732.14 / $3,903.06 / $4,098.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,706.97 / $2,236.75 / $3,960.68