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New Jersey 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 $10,471 · 10th–90th $10,471–$28,8400%20%40%90th$10,471Professionalmedian $14,125 · 10th–90th $11,220–$28,1840%10%10th90th$14,125$10.0K$20.0K$50.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,471.29 / $10,471.29 / $10,471.29
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,220.18 / $13,489.63 / $24,547.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $28,840.32
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,748.98 / $11,748.98 / $16,218.10
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19,054.61 / $26,915.35 / $38,904.51
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28,183.83 / $28,183.83 / $28,183.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,982.44 / $19,498.45 / $30,199.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,882.50 / $16,982.44 / $27,542.29