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Massachusetts rates for HCPCS L5859

Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)

Facilitymedian $7,413 · 10th–90th $7,413–$36,3080%20%40%90th$7,413Professionalmedian $11,749 · 10th–90th $7,413–$16,5960%20%10th90th$11,749$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
$7,413.10 / $7,413.10 / $7,413.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,413.10 / $8,709.64 / $14,791.08
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,022.64 / $16,595.87 / $83,176.38
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,943.28 / $12,882.50 / $17,378.01
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,772.37 / $9,772.37 / $9,772.37
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,317.64 / $8,317.64 / $10,000.00
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $3,630.78 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14,791.08 / $14,791.08 / $22,387.21
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,022.64 / $16,595.87 / $83,176.38
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,943.28 / $12,882.50 / $17,378.01
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $11,748.98 / $21,379.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,762.47 / $12,302.69 / $14,791.08