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Wisconsin 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 $17,783 · 10th–90th $16,596–$32,3590%50%10th90th$17,783Professionalmedian $13,183 · 10th–90th $7,762–$26,9150%20%10th90th$13,183$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
$8,912.51 / $8,912.51 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,585.78 / $8,912.51 / $15,135.61
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17,782.79 / $17,782.79 / $29,512.09
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,595.87 / $16,595.87 / $19,952.62
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,772.37 / $40,738.03 / $87,096.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,317.64 / $25,118.86 / $33,884.42
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,912.51 / $14,454.40 / $20,892.96
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,848.93 / $17,378.01 / $21,379.62
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,000.00 / $17,378.01 / $81,283.05
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,128.31 / $11,748.98 / $19,952.62
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $64.57 / $70.79
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,488.17 / $21,877.62 / $43,651.58
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17,782.79 / $26,915.35 / $48,977.88
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,772.37 / $35,481.34 / $81,283.05
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,317.64 / $16,595.87 / $89,125.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,332.54 / $12,302.69 / $17,782.79
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,760.83 / $8,709.64 / $14,454.40