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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

Facilitymedian $28,184 · 10th–90th $14,791–$30,9030%20%40%10th90th$28,184Professionalmedian $15,488 · 10th–90th $12,589–$26,3030%20%40%10th90th$15,488$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$14,791.08 / $15,135.61 / $15,135.61
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,589.25 / $14,791.08 / $22,387.21
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28,840.32 / $28,840.32 / $30,902.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17,378.01 / $17,378.01 / $36,307.81
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,595.87 / $16,595.87 / $19,952.62
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,022.64 / $16,218.10 / $16,218.10
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,748.98 / $11,748.98 / $11,748.98
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21,877.62 / $28,840.32 / $40,738.03
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14,454.40 / $19,054.61 / $28,183.83
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,302.69 / $20,417.38 / $33,113.11
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,488.17 / $17,378.01 / $18,620.87
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,748.98 / $22,387.21 / $38,904.51
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,748.98 / $22,387.21 / $38,904.51
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,000.00 / $19,498.45 / $35,481.34
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13,182.57 / $14,125.38 / $22,387.21