go back

Pennsylvania 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 $30,200 · 10th–90th $12,589–$48,9780%20%10th90th$30,200Professionalmedian $14,125 · 10th–90th $12,023–$25,7040%50%10th90th$14,125$1.0$10.0$100.0$1.0K$10.0K$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,589.25 / $48,977.88 / $48,977.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,302.69 / $14,125.38 / $24,547.09
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24,547.09 / $24,547.09 / $24,547.09
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28,183.83 / $28,183.83 / $28,183.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $25,703.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,748.98 / $11,748.98 / $16,982.44
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26,915.35 / $38,018.94 / $54,954.09
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28,840.32 / $28,840.32 / $28,840.32
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17,378.01 / $20,417.38 / $28,840.32
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19,054.61 / $19,054.61 / $19,952.62
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,589.25 / $12,589.25 / $12,589.25
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,302.69 / $13,803.84 / $21,877.62
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $38,904.51 / $56,234.13
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20,417.38 / $20,417.38 / $26,915.35
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20,417.38 / $20,417.38 / $26,915.35
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,748.98 / $35,481.34 / $40,738.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,022.64 / $15,488.17 / $28,840.32