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Ohio 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 $23,988 · 10th–90th $13,183–$39,8110%20%40%10th90th$23,988Professionalmedian $11,482 · 10th–90th $9,550–$19,9530%20%40%10th90th$11,482$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
$10,964.78 / $10,964.78 / $18,620.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,549.93 / $10,964.78 / $18,620.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22,908.68 / $23,988.33 / $48,977.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,220.18 / $13,803.84 / $29,512.09
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,220.18 / $19,054.61 / $26,915.35
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14,791.08 / $20,417.38 / $30,199.52
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14,454.40 / $14,454.40 / $15,135.61
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,715.19 / $10,715.19 / $14,454.40
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14,454.40 / $14,454.40 / $14,454.40
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,715.19 / $10,715.19 / $14,454.40
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,302.69 / $19,054.61 / $28,183.83
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19,952.62 / $19,952.62 / $19,952.62
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21,877.62 / $25,703.96 / $46,773.51
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,120.11 / $18,197.01 / $27,542.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,413.10 / $11,220.18 / $15,488.17