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Utah rates for HCPCS L5250

Hip disarticulation, Canadian type; molded socket, hip joint, single axis constant friction knee, shin, SACH foot

Facilitymedian $4,365 · 10th–90th $1,995–$7,7620%20%40%10th90th$4,365Professionalmedian $5,623 · 10th–90th $1,995–$36,3080%10%10th90th$5,623$50.0$200.0$1.0K$5.0K$20.0K

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
$1,995.26 / $1,995.26 / $1,995.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $3,890.45 / $36,307.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,365.16 / $4,365.16 / $4,365.16
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $4,466.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $5,754.40 / $7,413.10
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $7,762.47 / $7,762.47
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,495.41 / $5,623.41 / $8,709.64
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,762.47 / $7,762.47 / $7,943.28
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,623.41 / $7,943.28 / $9,332.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $4,168.69 / $4,677.35
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,090.30 / $6,025.60