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Utah rates for HCPCS L5570

Preparatory Above Knee - Knee Disarticulation Ischial Level Socket Non-Alignable System Pylon No Cover Sach Foot Thermoplastic Or Equal Direct Formed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$781.11 / $781.11 / $781.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$781.11 / $1,002.23 / $8,925.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,769.38 / $1,769.38 / $1,769.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,291.65 / $1,769.38 / $1,822.46
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,396.10 / $2,251.79 / $2,927.32
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,700.94 / $3,012.25 / $3,012.25
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,715.29 / $2,159.17 / $3,238.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,092.46 / $1,209.93 / $1,735.81