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Pennsylvania 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 $10,715 · 10th–90th $4,467–$17,3780%20%10th90th$10,715Professionalmedian $5,129 · 10th–90th $4,365–$9,1200%20%10th90th$5,129$1.0$10.0$100.0$1.0K$10.0K

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
$4,466.84 / $17,378.01 / $17,378.01
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,365.16 / $5,011.87 / $8,709.64
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,000.00 / $10,000.00 / $10,000.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $6,606.93 / $10,471.29
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,897.79 / $4,897.79 / $6,606.93
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,549.93 / $13,489.63 / $19,498.45
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,232.93 / $10,232.93 / $10,232.93
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,165.95 / $7,244.36 / $10,232.93
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $4,466.84
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,365.16 / $5,128.61 / $8,709.64
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $14,454.40 / $19,952.62
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,244.36 / $7,244.36 / $9,549.93
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,244.36 / $7,244.36 / $9,772.37
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $12,589.25 / $14,454.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,365.16 / $5,623.41 / $10,471.29