go back

North Carolina 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 $21,878 · 10th–90th $12,589–$48,9780%20%10th90th$21,878Professionalmedian $19,055 · 10th–90th $12,589–$22,3870%20%40%10th90th$19,055$1.0$10.0$100.0$1.0K$10.0K$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,877.62 / $21,877.62 / $21,877.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,589.25 / $17,782.79 / $21,877.62
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22,387.21 / $22,387.21 / $24,547.09
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 / $19,054.61
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13,489.63 / $14,454.40 / $19,054.61
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,022.64 / $23,442.29 / $40,738.03
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,715.19 / $19,498.45 / $23,988.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,481.54 / $14,454.40 / $20,417.38
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138,038.43 / $138,038.43 / $138,038.43
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147,910.84 / $147,910.84 / $213,796.21