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New Hampshire 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 $17,378 · 10th–90th $10,000–$20,8930%10%20%10th90th$17,378Professionalmedian $12,023 · 10th–90th $5,623–$15,8490%20%10th90th$12,023$5.0K$10.0K$20.0K$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 / $12,022.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,413.10 / $10,000.00 / $15,135.61
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17,378.01 / $18,620.87 / $21,379.62
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,623.41 / $5,623.41 / $5,623.41
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 / $27,542.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $10,715.19 / $12,302.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,244.36 / $12,302.69 / $14,791.08
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18,620.87 / $18,620.87 / $18,620.87