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Utah rates for HCPCS L5614

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

Facilitymedian $1,202 · 10th–90th $589–$2,0420%20%40%10th90th$1,202Professionalmedian $1,479 · 10th–90th $589–$8,7100%10%10th90th$1,479$50.0$100.0$200.0$500.0$1.0K$2.0K$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
$588.84 / $588.84 / $588.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $1,096.48 / $8,709.64
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $1,318.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $1,318.26
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $1,513.56 / $1,905.46
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,041.74 / $2,041.74
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,479.11 / $2,238.72
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,041.74 / $2,089.30
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,089.30 / $2,454.71
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $1,202.26 / $1,380.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $912.01 / $1,513.56