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Utah rates for HCPCS L5500

Initial Below Knee Ptb Type Socket Non-Alignable System Pylon No Cover Sach Foot Plaster Socket Direct Formed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$496.48 / $496.48 / $496.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.48 / $663.16 / $5,905.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$963.22 / $963.22 / $963.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$703.15 / $963.22 / $1,170.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$919.11 / $1,482.44 / $1,927.17
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,778.13 / $1,983.08 / $1,983.08
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,129.23 / $1,421.47 / $2,132.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$694.37 / $769.04 / $1,103.29