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New York 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 $7,413–$34,6740%20%10th90th$17,378Professionalmedian $8,913 · 10th–90th $5,623–$22,3870%10%20%10th90th$8,913$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
$6,456.54 / $13,803.84 / $19,498.45
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,413.10 / $8,912.51 / $13,803.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17,378.01 / $17,378.01 / $34,673.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,623.41 / $5,623.41 / $22,387.21
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13,182.57 / $14,125.38 / $14,125.38
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14,125.38 / $14,125.38 / $14,125.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,772.37 / $9,772.37 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,317.64 / $8,317.64 / $20,417.38
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17,378.01 / $28,840.32 / $67,608.30
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,220.18 / $18,197.01 / $33,113.11
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,220.18 / $11,748.98 / $12,302.69
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $53,703.18 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,481.54 / $16,595.87 / $16,595.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,244.36 / $12,302.69 / $47,863.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,623.41 / $11,481.54 / $28,840.32
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,964.78 / $11,481.54 / $11,481.54
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,220.18 / $11,481.54 / $11,748.98