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New York 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 $23,442 · 10th–90th $12,303–$53,7030%10%10th90th$23,442Professionalmedian $17,378 · 10th–90th $12,303–$38,9050%20%40%10th90th$17,378$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$10,471.29 / $22,908.68 / $32,359.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,220.18 / $14,125.38 / $22,908.68
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28,840.32 / $28,840.32 / $57,543.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17,378.01 / $18,197.01 / $45,708.82
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,877.62 / $23,442.29 / $23,442.29
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23,442.29 / $23,442.29 / $23,442.29
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,748.98 / $11,748.98 / $33,884.42
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28,840.32 / $47,863.01 / $112,201.85
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19,054.61 / $30,199.52 / $54,954.09
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,982.44 / $18,197.01 / $20,417.38
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22,908.68 / $22,908.68 / $22,908.68
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $53,703.18 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19,054.61 / $27,542.29 / $27,542.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,964.78 / $19,498.45 / $79,432.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,549.93 / $19,054.61 / $47,863.01
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,982.44 / $21,877.62
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,982.44 / $16,982.44 / $18,197.01