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Pennsylvania 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 $22,909 · 10th–90th $9,772–$38,0190%20%10th90th$22,909Professionalmedian $11,220 · 10th–90th $9,550–$19,9530%20%40%10th90th$11,220$1.0$10.0$100.0$1.0K$10.0K$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
$9,772.37 / $38,018.94 / $38,018.94
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,549.93 / $10,964.78 / $18,620.87
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21,877.62 / $21,877.62 / $21,877.62
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14,454.40 / $14,454.40 / $22,387.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,715.19 / $10,715.19 / $14,454.40
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20,417.38 / $29,512.09 / $42,657.95
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22,387.21 / $22,387.21 / $22,387.21
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13,489.63 / $15,488.17 / $22,387.21
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,772.37 / $9,772.37 / $9,772.37
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,549.93 / $11,220.18 / $18,620.87
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $30,902.95 / $42,657.95
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15,488.17 / $15,488.17 / $20,892.96
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,488.17 / $15,488.17 / $21,379.62
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,120.11 / $27,542.29 / $31,622.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,332.54 / $12,302.69 / $22,387.21