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Utah rates for HCPCS L5595

Preparatory, hip disarticulation/hemipelvectomy, pylon, no cover, SACH foot, thermoplastic or equal, molded to patient model

Facilitymedian $3,548 · 10th–90th $1,549–$4,7860%20%40%10th90th$3,548Professionalmedian $3,548 · 10th–90th $1,549–$28,1840%20%10th90th$3,548$50.0$200.0$1.0K$5.0K$20.0K

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
$1,548.82 / $1,548.82 / $1,548.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,884.03 / $28,183.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $3,548.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,630.27 / $3,548.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $3,548.13 / $4,570.88
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,570.88 / $4,786.30 / $4,786.30
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,467.37 / $3,467.37 / $5,370.32
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,786.30 / $4,786.30 / $5,495.41
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,467.37 / $4,897.79 / $6,606.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $3,235.94 / $4,365.16
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,398.83 / $3,890.45