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California rates for HCPCS L5856

Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type

Facilitymedian $15,136 · 10th–90th $11,749–$67,6080%20%10th90th$15,136Professionalmedian $16,218 · 10th–90th $12,303–$102,3290%20%10th90th$16,218$20.0$100.0$500.0$2.0K$10.0K$50.0K$200.0K

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
$15,488.17 / $15,848.93 / $123,026.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,589.25 / $15,488.17 / $107,151.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,748.98 / $15,135.61 / $64,565.42
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,488.17 / $17,378.01 / $40,738.03
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,982.44 / $41,686.94 / $66,069.34
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26,915.35 / $52,480.75 / $107,151.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $22,908.68
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,748.98 / $11,748.98 / $16,218.10
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,135.61 / $19,054.61 / $34,673.69
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17,378.01 / $25,703.96 / $44,668.36
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138,038.43 / $138,038.43 / $138,038.43
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147,910.84 / $213,796.21 / $213,796.21
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28,840.32 / $28,840.32 / $28,840.32
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,120.11 / $26,302.68 / $36,307.81
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,748.98 / $11,748.98 / $27,542.29
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53,703.18 / $53,703.18 / $53,703.18
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,135.61 / $19,498.45 / $25,703.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $17,378.01 / $35,481.34
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,022.64 / $15,488.17 / $29,512.09