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Utah rates for HCPCS L5301

Below Knee, Molded Socket, Shin, Sach Foot, Endoskeletal System

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$887.57 / $887.57 / $887.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$887.57 / $1,185.34 / $10,556.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,721.98 / $1,721.98 / $1,721.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,257.05 / $1,721.98 / $2,019.28
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,257.58 / $2,028.37 / $2,636.88
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,432.94 / $2,713.38 / $2,713.38
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,545.09 / $1,944.95 / $2,917.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,241.34 / $1,374.83 / $1,967.45