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Prosthetic Knee, Polycentric, Mechanical Stance Lock

Pennsylvania 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?

$501

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $501 for this service. The price depends on where it is billed: about $501 from a physician practice, and about $1,380 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 9 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$501$457 to $646
FacilityA hospital or hospital-owned outpatient department$1,380$457 to $1,778

How much rates vary

Facilitymedian $1,380 · 10th to 90th $457 to $3,311Professionalmedian $501 · 10th to 90th $417 to $851
$500$1K$2K$5K$10K$20K$50Kfacility $1,380professional $501

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
$457.09
Median
$457.09
Typical High
$1,778.28
Aetna
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$501.19
Typical High
$776.25
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$831.76
Typical High
$1,047.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$1,548.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$478.63
Typical High
$660.69
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$1,348.96
Typical High
$1,995.26
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,047.13
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$724.44
Typical High
$1,047.13
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$457.09
Typical High
$1,778.28
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$501.19
Typical High
$831.76
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$537.03
Median
$537.03
Typical High
$537.03
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$2,454.71
Typical High
$3,981.07
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$977.24
United
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$1,380.38
Typical High
$1,380.38
United
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$575.44
Typical High
$1,047.13

Where Pennsylvania 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.

Pennsylvania· 50th of 51

$501

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.