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Utah rates for HCPCS L5611

Addition to lower extremity, endoskeletal system, above knee (AK), knee disarticulation, four-bar linkage, with friction swing phase control

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$622.83 / $622.83 / $622.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$622.83 / $770.64 / $6,862.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,226.77 / $1,226.77 / $1,226.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$895.54 / $1,226.77 / $1,486.65
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,167.02 / $1,882.30 / $2,446.98
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,257.73 / $2,517.96 / $2,517.96
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,433.82 / $1,804.88 / $2,707.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$871.09 / $964.75 / $1,380.60