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New Hampshire 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 $22,387 · 10th–90th $12,303–$26,3030%20%40%10th90th$22,387Professionalmedian $14,791 · 10th–90th $10,000–$20,4170%20%10th90th$14,791$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,302.69 / $12,302.69 / $14,791.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,549.93 / $12,302.69 / $18,620.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22,387.21 / $23,988.33 / $26,915.35
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,589.25 / $12,589.25 / $12,589.25
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 / $35,481.34
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,165.95 / $13,803.84 / $15,135.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,332.54 / $15,135.61 / $19,054.61
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $21,379.62 / $31,622.78