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Utah rates for HCPCS L5280

Hemipelvectomy Canadian Type; Molded Socket Hip Joint Single Axis Constant Friction Knee Shin Sach Foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,968.27 / $1,968.27 / $1,968.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,968.27 / $2,639.93 / $23,509.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,728.96 / $4,728.96 / $4,728.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,452.14 / $4,728.96 / $4,870.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,668.60 / $5,917.10 / $7,692.23
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,097.32 / $7,915.37 / $7,915.37
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,507.29 / $5,673.74 / $8,510.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,755.58 / $3,048.83 / $4,363.00