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Prosthetic Knee, Polycentric, Hydraulic Swing Control

Montana rates for HCPCS L5814

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

Rates data updated July 2026.

Facilitymedian $4,467 · 10th–90th $2,818$5,4950%20%40%10th90th$4,467Professionalmedian $3,631 · 10th–90th $1,288$8,7100%10%20%10th90th$3,631$100.0$200.0$500.0$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
Professional
Modifier
Global
Typical Low
$1,288.25
Median
$3,630.78
Typical High
$19,054.61
BCBS
Setting
Professional
Modifier
Global
Typical Low
$4,466.84
Median
$4,466.84
Typical High
$4,466.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,511.89
Median
$4,786.30
Typical High
$4,786.30
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2,511.89
Median
$4,786.30
Typical High
$4,786.30
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$3,467.37
Median
$4,466.84
Typical High
$8,709.64
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$3,467.37
Median
$4,466.84
Typical High
$8,709.64
Providence
Setting
Facility
Modifier
Global
Typical Low
$2,137.96
Median
$4,168.69
Typical High
$6,456.54
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$3,548.13
Typical High
$4,786.30
United
Setting
Facility
Modifier
Global
Typical Low
$2,630.27
Median
$3,019.95
Typical High
$3,162.28
United
Setting
Professional
Modifier
Global
Typical Low
$1,819.70
Median
$1,995.26
Typical High
$3,090.30