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Maine 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 $33,884 · 10th–90th $16,218–$38,9050%20%10th90th$33,884Professionalmedian $16,982 · 10th–90th $12,589–$29,5120%10%10th90th$16,982$10.0K$20.0K$50.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,589.25 / $15,488.17 / $43,651.58
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28,183.83 / $33,884.42 / $38,904.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17,378.01 / $17,378.01 / $29,512.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $16,218.10
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,748.98 / $11,748.98 / $16,218.10
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25,118.86 / $25,118.86 / $30,199.52
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,589.25 / $16,595.87 / $19,054.61
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,317.64 / $16,982.44 / $16,982.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,220.18 / $24,547.09 / $25,118.86