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Michigan 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 $35,481 · 10th–90th $16,596–$117,4900%20%10th90th$35,481Professionalmedian $16,218 · 10th–90th $12,589–$28,8400%20%40%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
$16,595.87 / $16,595.87 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,302.69 / $14,791.08 / $21,877.62
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38,018.94 / $87,096.36 / $165,958.69
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28,840.32 / $28,840.32 / $30,199.52
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19,054.61 / $19,054.61 / $19,054.61
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 / $16,218.10 / $32,359.37
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,595.87 / $54,954.09 / $61,659.50
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14,791.08 / $22,908.68 / $35,481.34
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $16,218.10
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,748.98 / $19,054.61 / $28,840.32
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,982.44 / $23,442.29 / $35,481.34
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,715.19 / $13,803.84 / $20,417.38