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Ohio 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 $10,965 · 10th–90th $6,166–$18,1970%20%40%10th90th$10,965Professionalmedian $5,129 · 10th–90th $4,365–$9,1200%20%40%10th90th$5,129$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
$5,011.87 / $5,011.87 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,365.16 / $5,011.87 / $8,511.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,471.29 / $10,964.78 / $22,387.21
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,128.61 / $6,309.57 / $13,489.63
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,128.61 / $8,709.64 / $12,302.69
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,760.83 / $9,332.54 / $13,803.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $6,606.93 / $6,918.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,897.79 / $4,897.79 / $6,606.93
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $6,606.93 / $6,606.93
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,897.79 / $4,897.79 / $6,606.93
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,818.38 / $3,981.07 / $5,754.40
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,589.25 / $12,589.25 / $12,589.25
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,000.00 / $11,748.98 / $21,379.62
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $8,317.64 / $12,589.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $5,128.61 / $7,079.46