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Wisconsin 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 $20,417–$41,6870%20%40%10th90th$22,909Professionalmedian $16,596 · 10th–90th $9,772–$34,6740%20%10th90th$16,596$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
$11,220.18 / $11,220.18 / $11,220.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,772.37 / $11,220.18 / $18,620.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22,908.68 / $22,908.68 / $38,018.94
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20,417.38 / $21,379.62 / $25,118.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14,454.40 / $52,480.75 / $112,201.85
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,715.19 / $32,359.37 / $43,651.58
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,220.18 / $18,620.87 / $28,183.83
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20,417.38 / $27,542.29 / $33,884.42
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,220.18 / $22,387.21 / $104,712.85
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,232.93 / $14,454.40 / $25,118.86
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $64.57 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36,307.81 / $36,307.81 / $36,307.81
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,218.10 / $25,703.96 / $44,668.36
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22,908.68 / $34,673.69 / $63,095.73
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14,454.40 / $45,708.82 / $104,712.85
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,715.19 / $21,379.62 / $112,201.85
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,022.64 / $15,135.61 / $22,908.68
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,709.64 / $11,220.18 / $18,620.87