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Texas 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 $14,454 · 10th–90th $7,762–$35,4810%10%20%10th90th$14,454Professionalmedian $8,710 · 10th–90th $7,413–$15,1360%20%10th90th$8,710$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
$7,762.47 / $7,762.47 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,413.10 / $8,511.38 / $14,791.08
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,471.29 / $10,471.29 / $10,471.29
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,589.25 / $13,489.63 / $17,782.79
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15,488.17 / $15,488.17 / $15,488.17
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
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83,176.38 / $83,176.38 / $83,176.38
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91,201.08 / $128,824.96 / $128,824.96
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,317.64 / $16,982.44 / $25,118.86
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,585.78 / $8,912.51 / $17,378.01
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13,803.84 / $13,803.84 / $13,803.84
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,511.38 / $15,848.93 / $24,547.09
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,317.64 / $8,317.64 / $9,772.37
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,244.36 / $12,302.69 / $18,197.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,456.54 / $9,772.37 / $12,302.69
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,549.93 / $17,782.79 / $17,782.79