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Utah rates for HCPCS L5580

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

Facilitymedian $1,778 · 10th–90th $912–$3,4670%20%40%10th90th$1,778Professionalmedian $2,455 · 10th–90th $912–$16,2180%5%10%10th90th$2,455$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
$912.01 / $912.01 / $912.01
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,737.80 / $16,218.10
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 / $1,905.46
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $2,511.89 / $3,311.31
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $3,467.37 / $3,467.37
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,454.71 / $3,467.37
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,467.37 / $3,548.13
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,548.13 / $3,801.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,862.09 / $2,137.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,412.54 / $2,630.27