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Utah rates for HCPCS L2628

Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables

Facilitymedian $933 · 10th–90th $603–$2,5120%20%40%10th90th$933Professionalmedian $1,413 · 10th–90th $603–$8,1280%5%10%10th90th$1,413$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$602.56 / $602.56 / $602.56
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $1,318.26 / $8,128.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,174.90 / $1,174.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $1,202.26
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $1,819.70 / $2,398.83
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,511.89 / $2,511.89
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $2,818.38
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,511.89 / $2,570.40
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,570.40 / $3,090.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $933.25 / $1,071.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $933.25 / $1,445.44