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Utah rates for HCPCS L5220

Above knee (AK), short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each

Facilitymedian $2,291 · 10th–90th $1,072–$3,6310%20%40%10th90th$2,291Professionalmedian $2,630 · 10th–90th $1,072–$19,0550%10%10th90th$2,630$50.0$200.0$1.0K$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
$1,071.52 / $1,071.52 / $1,071.52
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,995.26 / $19,054.61
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,454.71 / $2,454.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,819.70 / $2,454.71
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,630.27 / $3,467.37
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $3,630.78 / $3,630.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,570.40 / $4,073.80
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,630.78 / $3,630.78 / $4,466.84
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $3,715.35 / $5,370.32
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,187.76 / $2,511.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,659.59 / $2,884.03