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Texas 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 $12,882–$52,4810%20%10th90th$23,442Professionalmedian $13,804 · 10th–90th $12,023–$24,5470%50%10th90th$13,804$20.0$100.0$500.0$2.0K$10.0K$50.0K$200.0K

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
$12,882.50 / $12,882.50 / $13,803.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,589.25 / $14,125.38 / $25,703.96
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $16,218.10
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,388.44 / $4,168.69
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13,803.84 / $13,803.84 / $13,803.84
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20,892.96 / $22,387.21 / $29,512.09
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25,703.96 / $25,703.96 / $25,703.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $16,218.10
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,748.98 / $11,748.98 / $16,218.10
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138,038.43 / $138,038.43 / $138,038.43
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147,910.84 / $213,796.21 / $213,796.21
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,589.25 / $23,442.29 / $37,153.52
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,589.25 / $14,125.38 / $28,840.32
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21,877.62 / $21,877.62 / $22,387.21
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,589.25 / $22,908.68 / $37,153.52
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,748.98 / $11,748.98 / $16,218.10
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,748.98 / $20,417.38 / $30,199.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,715.19 / $15,848.93 / $19,952.62
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,848.93 / $29,512.09 / $29,512.09