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Endoskeletal Knee, Microprocessor Swing and Stance Control

Virginia 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?

$17,378

Typical negotiated rate. In Virginia, July 2026.

Insurers have agreed to pay about $17,378 for this service. The price depends on where it is billed: about $15,136 from a physician practice, and about $28,184 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 8 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$15,136$14,791 to $19,055
FacilityA hospital or hospital-owned outpatient department$28,184$18,621 to $28,840

How much rates vary

Facilitymedian $28,184 · 10th to 90th $14,791 to $30,903Professionalmedian $15,136 · 10th to 90th $12,303 to $26,915
$10K$20K$50Kfacility $28,184professional $15,136

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
$14,791.08
Median
$14,791.08
Typical High
$15,135.61
Aetna
Setting
Professional
Modifier
Global
Typical Low
$12,302.69
Median
$14,791.08
Typical High
$15,488.17
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$28,840.32
Median
$28,840.32
Typical High
$30,902.95
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$17,378.01
Median
$17,378.01
Typical High
$36,307.81
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$16,595.87
Median
$16,595.87
Typical High
$19,952.62
Cigna
Setting
Facility
Modifier
Global
Typical Low
$12,022.64
Median
$16,218.10
Typical High
$16,218.10
Cigna
Setting
Professional
Modifier
Global
Typical Low
$11,748.98
Median
$11,748.98
Typical High
$11,748.98
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$21,877.62
Median
$28,840.32
Typical High
$40,738.03
Medcost
Setting
Professional
Modifier
Global
Typical Low
$14,454.40
Median
$19,054.61
Typical High
$28,183.83
Medcost
Setting
Facility
Modifier
Global
Typical Low
$12,302.69
Median
$20,417.38
Typical High
$33,113.11
Medcost
Setting
Professional
Modifier
Global
Typical Low
$15,488.17
Median
$17,378.01
Typical High
$18,620.87
Sentara
Setting
Facility
Modifier
Global
Typical Low
$11,748.98
Median
$22,387.21
Typical High
$38,904.51
Sentara
Setting
Professional
Modifier
Global
Typical Low
$11,748.98
Median
$22,387.21
Typical High
$38,904.51
United
Setting
Facility
Modifier
Global
Typical Low
$10,000.00
Median
$19,498.45
Typical High
$35,481.34
United
Setting
Professional
Modifier
Global
Typical Low
$13,182.57
Median
$14,125.38
Typical High
$21,877.62

Where Virginia 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.

Virginia· 23rd of 51

$17,378

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.