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Hawaii rates for HCPCS L5858

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

Facilitymedian $14,454 · 10th–90th $13,183–$17,3780%20%10th90th$14,454Professionalmedian $13,183 · 10th–90th $9,550–$22,3870%20%10th90th$13,183$10.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,549.93 / $12,022.64 / $18,620.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14,454.40 / $14,454.40 / $17,378.01
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14,454.40 / $20,417.38 / $27,542.29
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22,387.21 / $22,387.21 / $22,387.21
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,488.17 / $22,387.21 / $25,703.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13,182.57 / $13,489.63 / $15,848.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,748.98 / $15,135.61 / $23,988.33