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Maine 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 $25,704 · 10th–90th $14,454–$29,5120%20%40%10th90th$25,704Professionalmedian $12,882 · 10th–90th $9,550–$22,3870%10%20%10th90th$12,882$10.0K$20.0K$50.0K$100.0K

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 / $11,748.98 / $33,884.42
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $25,703.96 / $29,512.09
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,589.25 / $12,589.25 / $22,387.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14,454.40 / $14,454.40 / $14,454.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,715.19 / $10,715.19 / $14,454.40
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19,054.61 / $19,054.61 / $22,908.68
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,549.93 / $12,882.50 / $14,791.08
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,309.57 / $13,182.57 / $13,182.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,511.38 / $19,054.61 / $19,054.61