go back

Ohio 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 $19,055 · 10th–90th $9,772–$30,9030%20%40%10th90th$19,055Professionalmedian $8,318 · 10th–90th $5,623–$15,1360%20%10th90th$8,318$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
$8,511.38 / $8,511.38 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,413.10 / $8,511.38 / $14,791.08
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17,782.79 / $19,054.61 / $38,018.94
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,623.41 / $7,079.46 / $22,908.68
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,709.64 / $15,135.61 / $20,892.96
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,481.54 / $15,848.93 / $23,988.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,772.37 / $9,772.37 / $10,232.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,317.64 / $8,317.64 / $9,772.37
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,772.37 / $9,772.37 / $9,772.37
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,317.64 / $8,317.64 / $9,772.37
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,232.93 / $15,848.93 / $23,442.29
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19,952.62 / $19,952.62 / $19,952.62
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,982.44 / $19,952.62 / $37,153.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,244.36 / $14,454.40 / $21,379.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,888.44 / $8,709.64 / $12,882.50