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Michigan 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 $10,471 · 10th–90th $9,772–$21,3800%20%40%10th90th$10,471Professionalmedian $9,772 · 10th–90th $7,586–$17,3780%20%10th90th$9,772$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
$10,000.00 / $10,000.00 / $10,000.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,413.10 / $9,120.11 / $13,182.57
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17,378.01 / $17,378.01 / $17,378.01
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17,378.01 / $17,378.01 / $18,197.01
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,481.54 / $11,481.54 / $11,481.54
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 / $9,772.37 / $19,498.45
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,000.00 / $31,622.78 / $35,481.34
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,120.11 / $13,182.57 / $21,379.62
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,772.37 / $9,772.37 / $9,772.37
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,317.64 / $14,454.40 / $17,378.01
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,471.29 / $14,454.40 / $21,379.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,456.54 / $8,317.64 / $13,489.63