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Endoskeletal Knee, Microprocessor Swing and Stance Control

Massachusetts 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?

$25,119

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $25,119 for this service. The price depends on where it is billed: about $24,547 from a physician practice, and about $35,481 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$24,547$13,804 to $25,119
FacilityA hospital or hospital-owned outpatient department$35,481$28,184 to $41,687

How much rates vary

Facilitymedian $35,481 · 10th to 90th $12,589 to $50,119Professionalmedian $24,547 · 10th to 90th $12,589 to $38,019
$100$1K$10K$100Kfacility $35,481professional $24,547

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
$12,589.25
Median
$12,589.25
Typical High
$12,589.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$12,589.25
Median
$13,803.84
Typical High
$39,810.72
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$27,542.29
Median
$28,183.83
Typical High
$138,038.43
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$12,882.50
Median
$23,442.29
Typical High
$34,673.69
BCBS
Setting
Facility
Modifier
Global
Typical Low
$32,359.37
Median
$37,153.52
Typical High
$48,977.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$16,218.10
Median
$16,218.10
Typical High
$16,218.10
Cigna
Setting
Professional
Modifier
Global
Typical Low
$11,748.98
Median
$11,748.98
Typical High
$33,884.42
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$3,630.78
Typical High
$9,772.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$25,118.86
Median
$25,118.86
Typical High
$38,018.94
Health New England
Setting
Professional
Modifier
Global
Typical Low
$16,982.44
Median
$16,982.44
Typical High
$16,982.44
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$27,542.29
Median
$28,183.83
Typical High
$138,038.43
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$12,882.50
Median
$23,442.29
Typical High
$34,673.69
United
Setting
Facility
Modifier
Global
Typical Low
$10,715.19
Median
$19,952.62
Typical High
$35,481.34
United
Setting
Professional
Modifier
Global
Typical Low
$12,882.50
Median
$23,988.33
Typical High
$25,703.96

Where Massachusetts 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.

Massachusetts· 7th of 51

$25,119

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.