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New York rates for HCPCS L5816

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

Facilitymedian $813 · 10th–90th $447$1,8620%20%10th90th$813Professionalmedian $617 · 10th–90th $447$1,5140%20%40%10th90th$617$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
$371.54 / $831.76 / $1,174.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $537.03 / $851.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $2,089.30
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $1,778.28
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $851.14 / $851.14
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $851.14
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $1,174.90
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,737.80 / $3,981.07
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $1,047.13 / $1,995.26
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $676.08
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $645.65 / $645.65
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $1,000.00 / $1,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $758.58 / $2,884.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $676.08 / $1,737.80
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $630.96 / $676.08
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $645.65 / $645.65