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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,589.25 / $48,977.88 / $48,977.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,302.69 / $14,454.40 / $24,547.09
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28,183.83 / $28,183.83 / $28,183.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,218.10 / $16,218.10 / $28,840.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,748.98 / $11,748.98 / $16,982.44
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26,915.35 / $38,018.94 / $54,954.09
Geisinger
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28,840.32 / $28,840.32 / $28,840.32
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17,378.01 / $20,417.38 / $28,840.32
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19,054.61 / $19,054.61 / $19,952.62
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,589.25 / $12,589.25 / $48,977.88
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,302.69 / $14,454.40 / $25,703.96
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45,708.82 / $45,708.82 / $45,708.82
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $38,904.51 / $56,234.13
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,417.38 / $20,417.38 / $26,915.35
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20,417.38 / $20,417.38 / $27,542.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,748.98 / $35,481.34 / $42,657.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,882.50 / $15,488.17 / $25,703.96