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Utah rates for HCPCS L5620

Addition to lower extremity, test socket, below knee (BK)

Facilitymedian $209 · 10th–90th $107–$3310%20%40%10th90th$209Professionalmedian $240 · 10th–90th $107–$1,5140%10%10th90th$240$50.0$100.0$200.0$500.0$1.0K

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
$107.15 / $107.15 / $107.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $199.53 / $1,513.56
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $208.93
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $245.47 / $316.23
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $331.13 / $331.13
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $371.54
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $354.81
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $338.84 / $436.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $173.78 / $251.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $165.96 / $269.15