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Endoskeletal Knee, Microprocessor Swing and Stance Control

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

Rates data updated July 2026.

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

$21,878

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $21,878 for this service. The price depends on where it is billed: about $21,878 from a physician practice, and about $22,387 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$21,878$15,136 to $22,387
FacilityA hospital or hospital-owned outpatient department$22,387$18,621 to $29,512

How much rates vary

Facilitymedian $22,387 · 10th to 90th $13,183 to $46,774Professionalmedian $21,878 · 10th to 90th $12,589 to $22,387
$10K$20K$50K$100Kfacility $22,387professional $21,878

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
$21,877.62
Median
$21,877.62
Typical High
$21,877.62
Aetna
Setting
Professional
Modifier
Global
Typical Low
$12,302.69
Median
$21,877.62
Typical High
$21,877.62
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$26,915.35
Median
$26,915.35
Typical High
$26,915.35
BCBS
Setting
Facility
Modifier
Global
Typical Low
$23,988.33
Median
$28,840.32
Typical High
$57,543.99
BCBS
Setting
Professional
Modifier
Global
Typical Low
$22,387.21
Median
$22,387.21
Typical High
$24,547.09
Cigna
Setting
Facility
Modifier
Global
Typical Low
$16,218.10
Median
$16,218.10
Typical High
$16,982.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$11,748.98
Median
$11,748.98
Typical High
$19,054.61
Medcost
Setting
Professional
Modifier
Global
Typical Low
$13,489.63
Median
$14,454.40
Typical High
$19,054.61
Medcost
Setting
Facility
Modifier
Global
Typical Low
$12,022.64
Median
$23,442.29
Typical High
$40,738.03
United
Setting
Facility
Modifier
Global
Typical Low
$16,982.44
Median
$23,988.33
Typical High
$29,512.09
United
Setting
Professional
Modifier
Global
Typical Low
$11,481.54
Median
$14,454.40
Typical High
$20,417.38
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$138,038.43
Median
$138,038.43
Typical High
$138,038.43
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$147,910.84
Median
$147,910.84
Typical High
$213,796.21

Where North Carolina 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.

North Carolina· 14th of 51

$21,878

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.