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Endoskeletal Knee, Microprocessor Swing and Stance Control

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

Rates data updated July 2026.

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

$16,596

Typical negotiated rate. In Michigan, July 2026.

Insurers have agreed to pay about $16,596 for this service. The price depends on where it is billed: about $16,596 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 7 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$16,596$14,791 to $28,840
FacilityA hospital or hospital-owned outpatient department$35,481$16,596 to $77,625

How much rates vary

Facilitymedian $35,481 · 10th to 90th $16,596 to $117,490Professionalmedian $16,596 · 10th to 90th $13,490 to $28,840
$1K$10K$100Kfacility $35,481professional $16,596

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
$16,595.87
Median
$16,595.87
Typical High
$16,595.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$13,803.84
Median
$15,488.17
Typical High
$16,595.87
BCBS
Setting
Facility
Modifier
Global
Typical Low
$38,018.94
Median
$87,096.36
Typical High
$165,958.69
BCBS
Setting
Professional
Modifier
Global
Typical Low
$27,542.29
Median
$28,840.32
Typical High
$30,199.52
CareSource
Setting
Facility
Modifier
Global
Typical Low
$19,054.61
Median
$19,054.61
Typical High
$19,054.61
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
$16,218.10
Typical High
$32,359.37
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$16,595.87
Median
$54,954.09
Typical High
$61,659.50
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$14,454.40
Median
$23,442.29
Typical High
$35,481.34
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$14,791.08
Median
$23,988.33
Typical High
$32,359.37
United
Setting
Facility
Modifier
Global
Typical Low
$16,982.44
Median
$23,442.29
Typical High
$35,481.34
United
Setting
Professional
Modifier
Global
Typical Low
$10,715.19
Median
$13,803.84
Typical High
$20,892.96

Where Michigan 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.

Michigan· 26th of 51

$16,596

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.