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Endoskeletal Knee, Microprocessor Swing and Stance Control

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

Rates data updated July 2026.

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

$19,055

Typical negotiated rate. In Maine, July 2026.

Insurers have agreed to pay about $19,055 for this service. The price depends on where it is billed: about $18,197 from a physician practice, and about $33,884 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$18,197$15,488 to $25,119
FacilityA hospital or hospital-owned outpatient department$33,884$20,417 to $33,884

How much rates vary

Facilitymedian $33,884 · 10th to 90th $16,218 to $38,905Professionalmedian $18,197 · 10th to 90th $12,589 to $25,119
$10K$20K$50Kfacility $33,884professional $18,197

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$12,589.25
Median
$15,488.17
Typical High
$19,054.61
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$28,183.83
Median
$33,884.42
Typical High
$38,904.51
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$17,378.01
Median
$17,378.01
Typical High
$29,512.09
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
$16,218.10
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$25,118.86
Median
$25,118.86
Typical High
$30,199.52
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$8,317.64
Median
$15,488.17
Typical High
$19,054.61
United
Setting
Facility
Modifier
Global
Typical Low
$8,317.64
Median
$16,982.44
Typical High
$20,417.38
United
Setting
Professional
Modifier
Global
Typical Low
$11,220.18
Median
$24,547.09
Typical High
$25,118.86

Where Maine 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.

Maine· 18th of 51

$19,055

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.