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Washington 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 $10,233 · 10th–90th $6,457–$24,5470%10%20%10th90th$10,233Professionalmedian $7,244 · 10th–90th $4,571–$14,7910%20%10th90th$7,244$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
$6,456.54 / $6,456.54 / $15,488.17
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,466.84 / $5,495.41 / $9,120.11
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,709.64 / $9,772.37 / $9,772.37
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,709.64 / $8,709.64 / $11,220.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $6,606.93 / $6,606.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,897.79 / $4,897.79 / $6,606.93
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,754.40 / $13,803.84 / $28,183.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,754.40 / $12,022.64 / $21,379.62
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $7,762.47 / $8,511.38
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,772.37 / $10,000.00 / $10,232.93
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,709.64 / $14,791.08 / $19,952.62
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,317.64 / $8,317.64 / $9,772.37
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,772.37 / $9,772.37 / $9,772.37
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,709.64 / $8,709.64 / $11,220.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,025.60 / $15,135.61 / $15,135.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,365.16 / $6,309.57 / $8,709.64
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,244.36 / $8,709.64 / $15,488.17