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Ohio 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 $30,903 · 10th–90th $16,218–$51,2860%20%10th90th$30,903Professionalmedian $14,791 · 10th–90th $12,023–$25,7040%20%40%10th90th$14,791$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
$14,125.38 / $14,125.38 / $23,988.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,302.69 / $14,125.38 / $23,988.33
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$29,512.09 / $30,902.95 / $63,095.73
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14,454.40 / $18,197.01 / $38,018.94
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24,547.09 / $24,547.09 / $24,547.09
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14,454.40 / $24,547.09 / $34,673.69
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19,054.61 / $26,302.68 / $38,904.51
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $16,982.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,748.98 / $11,748.98 / $16,218.10
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $16,218.10
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,748.98 / $11,748.98 / $16,218.10
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,848.93 / $25,118.86 / $36,307.81
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19,952.62 / $19,952.62 / $19,952.62
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28,183.83 / $33,113.11 / $60,255.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,748.98 / $23,442.29 / $35,481.34
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,549.93 / $14,454.40 / $19,952.62