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Utah rates for HCPCS L5570

Preparatory, above knee (AK), knee disarticulation, ischial level socket, nonalignable system, pylon, no cover, SACH foot, thermoplastic or equal, direct formed

Facilitymedian $1,622 · 10th–90th $776–$3,0900%20%40%10th90th$1,622Professionalmedian $2,188 · 10th–90th $776–$13,4900%10%10th90th$2,188$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
$776.25 / $776.25 / $776.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,548.82 / $13,489.63
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $1,778.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,288.25 / $1,778.28
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $2,238.72 / $2,884.03
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,951.21 / $3,090.30 / $3,090.30
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,187.76 / $3,090.30
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,090.30 / $3,162.28
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,162.28 / $3,311.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,548.82 / $1,819.70
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,202.26 / $2,344.23