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Prosthetic Knee, Polycentric, Mechanical Stance Lock

Illinois rates for HCPCS L5816

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

Rates data updated July 2026.

How much does Prosthetic Knee, Polycentric, Mechanical Stance Lock cost?

$550

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $550 for this service. The price depends on where it is billed: about $550 from a physician practice, and about $1,047 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$550$501 to $851
FacilityA hospital or hospital-owned outpatient department$1,047$501 to $1,862

How much rates vary

Facilitymedian $1,047 · 10th to 90th $501 to $5,248Professionalmedian $550 · 10th to 90th $479 to $1,122
$500$1K$2K$5K$10Kfacility $1,047professional $550

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$501.19
Typical High
$1,047.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$537.03
Typical High
$1,047.13
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,230.27
Median
$1,995.26
Typical High
$7,079.46
Cigna
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$1,148.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$478.63
Typical High
$1,122.02
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,288.25
Typical High
$1,548.82
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$1,318.26
Median
$1,318.26
Typical High
$1,318.26
Molina
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$575.44
Typical High
$831.76
United
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$831.76
Typical High
$1,122.02
United
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$512.86
Typical High
$912.01

Where Illinois sits

The same service costs 4.5 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Illinois· 41st of 51

$550

HI $2,042DE $457

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.