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Utah rates for HCPCS L5500

Initial, below knee (BK) PTB type socket, nonalignable system, pylon, no cover, SACH foot, plaster socket, direct formed

Facilitymedian $955 · 10th–90th $501–$2,0420%20%40%10th90th$955Professionalmedian $1,288 · 10th–90th $501–$8,9130%10%10th90th$1,288$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
$501.19 / $501.19 / $501.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $1,023.29 / $8,912.51
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $954.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $1,000.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $1,479.11 / $1,905.46
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,041.74 / $2,041.74
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,445.44 / $1,819.70
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,041.74 / $2,089.30
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,949.84 / $2,089.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $1,023.29 / $1,148.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $776.25 / $1,513.56