go back

Utah rates for HCPCS L5614

Addition To Lower Extremity Exoskeletal System Above Knee- Knee Disarticulation 4 Bar Linkage With Pneumatic Swing Phase Control

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$586.11 / $586.11 / $586.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$586.11 / $644.17 / $5,736.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,317.79 / $1,317.79 / $1,317.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$961.99 / $1,317.79 / $1,803.52
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$932.15 / $1,503.47 / $1,954.51
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,803.35 / $2,011.21 / $2,011.21
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,145.25 / $1,441.64 / $2,162.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$819.74 / $907.89 / $1,302.47