go back

Utah rates for HCPCS L5595

Preparatory Hip Disarticulation-Hemipelvectomy Pylon No Cover Sach Foot Thermoplastic Or Equal Molded To Patient Model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,556.51 / $1,556.51 / $1,556.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,556.51 / $2,087.66 / $18,591.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,578.08 / $3,578.08 / $3,578.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,612.00 / $2,612.00 / $6,476.63
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.38 / $3,528.04 / $4,586.45
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,231.74 / $4,719.50 / $4,719.50
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,687.45 / $3,382.94 / $5,074.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,176.94 / $2,411.02 / $3,458.91