go back

New York rates for HCPCS L5857

Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type

Facilitymedian $8,511 · 10th–90th $4,467$20,8930%20%10th90th$8,511Professionalmedian $5,623 · 10th–90th $4,467$15,1360%20%10th90th$5,623$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$3,715.35 / $8,128.31 / $11,481.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $5,011.87 / $8,128.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,471.29 / $10,471.29 / $20,892.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,623.41 / $5,623.41 / $16,982.44
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,943.28 / $8,511.38 / $8,511.38
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,511.38 / $8,511.38 / $8,511.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $6,606.93 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,897.79 / $4,897.79 / $12,022.64
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,471.29 / $16,982.44 / $39,810.72
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,760.83 / $10,964.78 / $19,498.45
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,165.95 / $6,456.54 / $7,244.36
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $53,703.18 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,760.83 / $10,000.00 / $10,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,890.45 / $6,918.31 / $28,183.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $6,760.83 / $17,782.79
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,495.41 / $6,165.95 / $6,165.95
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,165.95 / $6,165.95 / $6,456.54