go back

Endoskeletal Knee, Microprocessor Swing and Stance Control

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

Rates data updated July 2026.

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

$16,596

Typical negotiated rate. In Ohio, July 2026.

Insurers have agreed to pay about $16,596 for this service. The price depends on where it is billed: about $15,849 from a physician practice, and about $30,200 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 9 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$15,849$14,125 to $20,893
FacilityA hospital or hospital-owned outpatient department$30,200$23,988 to $34,674

How much rates vary

Facilitymedian $30,200 · 10th to 90th $14,454 to $50,119Professionalmedian $15,849 · 10th to 90th $11,749 to $30,903
$10K$20K$50K$100Kfacility $30,200professional $15,849

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
$14,125.38
Median
$14,125.38
Typical High
$23,988.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$13,182.57
Median
$14,125.38
Typical High
$24,547.09
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$29,512.09
Median
$30,902.95
Typical High
$63,095.73
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$14,454.40
Median
$18,197.01
Typical High
$38,018.94
Aultcare
Setting
Professional
Modifier
Global
Typical Low
$25,118.86
Median
$25,118.86
Typical High
$25,118.86
CareSource
Setting
Facility
Modifier
Global
Typical Low
$14,454.40
Median
$24,547.09
Typical High
$34,673.69
CareSource
Setting
Professional
Modifier
Global
Typical Low
$19,054.61
Median
$26,302.68
Typical High
$38,904.51
Cigna
Setting
Facility
Modifier
Global
Typical Low
$16,218.10
Median
$16,218.10
Typical High
$17,782.79
Cigna
Setting
Professional
Modifier
Global
Typical Low
$11,748.98
Median
$11,748.98
Typical High
$19,952.62
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$16,218.10
Median
$16,218.10
Typical High
$16,982.44
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$11,748.98
Median
$11,748.98
Typical High
$16,218.10
Molina
Setting
Professional
Modifier
Global
Typical Low
$15,848.93
Median
$25,118.86
Typical High
$36,307.81
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$29,512.09
Median
$33,113.11
Typical High
$60,255.96
United
Setting
Facility
Modifier
Global
Typical Low
$16,982.44
Median
$23,442.29
Typical High
$30,199.52
United
Setting
Professional
Modifier
Global
Typical Low
$9,549.93
Median
$14,454.40
Typical High
$20,417.38

Where Ohio 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.

Ohio· 27th of 51

$16,596

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.