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Endoskeletal Knee, Microprocessor Swing and Stance Control

Illinois 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

Rates data updated July 2026.

How much does Endoskeletal Knee, Microprocessor Swing and Stance Control cost?

$22,387

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $22,387 for this service. The price depends on where it is billed: about $22,387 from a physician practice, and about $27,542 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$22,387$14,454 to $22,387
FacilityA hospital or hospital-owned outpatient department$27,542$14,454 to $52,481

How much rates vary

Facilitymedian $27,542 · 10th to 90th $14,454 to $147,911Professionalmedian $22,387 · 10th to 90th $13,490 to $29,512
$10K$20K$50K$100K$200Kfacility $27,542professional $22,387

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
$14,454.40
Median
$14,454.40
Typical High
$29,512.09
Aetna
Setting
Professional
Modifier
Global
Typical Low
$12,882.50
Median
$14,454.40
Typical High
$29,512.09
BCBS
Setting
Facility
Modifier
Global
Typical Low
$26,915.35
Median
$54,954.09
Typical High
$199,526.23
BCBS
Setting
Professional
Modifier
Global
Typical Low
$22,387.21
Median
$22,387.21
Typical High
$22,387.21
Cigna
Setting
Facility
Modifier
Global
Typical Low
$16,218.10
Median
$16,218.10
Typical High
$32,359.37
Cigna
Setting
Professional
Modifier
Global
Typical Low
$11,748.98
Median
$11,748.98
Typical High
$31,622.78
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$24,547.09
Median
$31,622.78
Typical High
$39,810.72
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
$38,018.94
Median
$38,018.94
Typical High
$38,018.94
Molina
Setting
Professional
Modifier
Global
Typical Low
$5,011.87
Median
$17,782.79
Typical High
$25,118.86
United
Setting
Facility
Modifier
Global
Typical Low
$17,378.01
Median
$23,442.29
Typical High
$29,512.09
United
Setting
Professional
Modifier
Global
Typical Low
$10,964.78
Median
$14,454.40
Typical High
$25,118.86

Where Illinois sits

The same service costs 2.3 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· 13th of 51

$22,387

HI $29,512DE $12,589

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.