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Vermont 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 $16,218 · 10th–90th $16,218–$20,4170%50%90th$16,218Professionalmedian $13,804 · 10th–90th $12,589–$19,0550%50%10th90th$13,804$10.0K$20.0K$50.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,589.25 / $13,803.84 / $17,782.79
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22,908.68 / $22,908.68 / $22,908.68
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
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22,387.21 / $22,387.21 / $28,183.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,982.44 / $16,982.44 / $20,417.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,232.93 / $19,952.62 / $57,543.99