go back

Utah rates for HCPCS L5613

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

Facilitymedian $1,905 · 10th–90th $955–$3,7150%20%40%10th90th$1,905Professionalmedian $2,455 · 10th–90th $955–$16,9820%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
$954.99 / $954.99 / $954.99
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,862.09 / $16,982.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $1,949.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $2,691.53 / $3,467.37
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,715.35 / $3,715.35
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,630.27 / $3,311.31
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,715.35 / $3,801.89
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $3,801.89 / $3,801.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,949.84 / $2,187.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,479.11 / $2,884.03