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Pennsylvania 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 $18,197 · 10th–90th $7,586–$29,5120%20%10th90th$18,197Professionalmedian $8,710 · 10th–90th $7,413–$15,4880%20%40%10th90th$8,710$1.0$10.0$100.0$1.0K$10.0K$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $29,512.09 / $29,512.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,413.10 / $8,511.38 / $14,791.08
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,982.44 / $16,982.44 / $16,982.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,772.37 / $9,772.37 / $15,488.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,317.64 / $8,317.64 / $9,772.37
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,218.10 / $22,908.68 / $33,113.11
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17,378.01 / $17,378.01 / $17,378.01
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,471.29 / $12,302.69 / $17,378.01
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $7,585.78 / $7,585.78
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,413.10 / $8,709.64 / $14,791.08
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $15,488.17 / $33,884.42
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,302.69 / $12,302.69 / $16,218.10
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,302.69 / $16,218.10 / $16,595.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,244.36 / $21,379.62 / $24,547.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,244.36 / $9,772.37 / $17,378.01