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Maine 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 $19,953 · 10th–90th $9,772–$22,9090%20%40%10th90th$19,953Professionalmedian $10,000 · 10th–90th $6,761–$14,7910%10%10th90th$10,000$5.0K$10.0K$20.0K$50.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,413.10 / $8,912.51 / $11,481.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,982.44 / $20,417.38 / $22,908.68
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,623.41 / $5,623.41 / $6,309.57
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 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14,791.08 / $14,791.08 / $17,782.79
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,413.10 / $10,000.00 / $11,481.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $10,471.29 / $10,471.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,606.93 / $14,791.08 / $15,135.61