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New York 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 $17,783 · 10th–90th $9,550–$44,6680%10%20%10th90th$17,783Professionalmedian $12,589 · 10th–90th $9,550–$32,3590%20%10th90th$12,589$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$8,128.31 / $17,782.79 / $25,118.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,511.38 / $10,964.78 / $17,782.79
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22,387.21 / $22,387.21 / $44,668.36
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,589.25 / $12,589.25 / $37,153.52
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,982.44 / $18,197.01 / $18,197.01
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18,197.01 / $18,197.01 / $18,197.01
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14,454.40 / $14,454.40 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,715.19 / $10,715.19 / $26,302.68
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22,387.21 / $37,153.52 / $85,113.80
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14,454.40 / $23,442.29 / $42,657.95
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13,182.57 / $14,125.38 / $15,848.93
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $53,703.18 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14,454.40 / $21,379.62 / $21,379.62
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,317.64 / $15,135.61 / $61,659.50
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,244.36 / $14,454.40 / $37,153.52
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,748.98 / $13,182.57 / $13,182.57
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13,182.57 / $13,182.57 / $14,125.38