go back

Utah rates for HCPCS L5626

Addition to lower extremity, test socket, hip disarticulation

Facilitymedian $380 · 10th–90th $182–$5750%20%40%10th90th$380Professionalmedian $417 · 10th–90th $182–$2,8180%10%10th90th$417$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$181.97 / $181.97 / $181.97
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $346.74 / $2,818.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $489.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $416.87 / $537.03
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $575.44 / $575.44
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $645.65
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $676.08
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $588.84 / $794.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $331.13 / $426.58
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $288.40 / $457.09