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Utah rates for HCPCS L2622

Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each

Facilitymedian $214 · 10th–90th $112–$3470%20%40%10th90th$214Professionalmedian $245 · 10th–90th $112–$1,9950%10%10th90th$245$50.0$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $218.78 / $1,995.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $213.80
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $251.19 / $331.13
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $346.74 / $346.74
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $389.05
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $354.81
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $354.81 / $426.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $173.78 / $257.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $173.78 / $275.42