go back

Utah rates for HCPCS L5629

Addition to lower extremity, below knee, acrylic socket

Facilitymedian $245 · 10th–90th $123–$3800%20%40%10th90th$245Professionalmedian $275 · 10th–90th $123–$1,6600%10%10th90th$275$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
$123.03 / $123.03 / $123.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $229.09 / $1,659.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $245.47
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $275.42 / $363.08
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $380.19 / $380.19
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $426.58
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $389.05
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $389.05 / $467.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $245.47 / $288.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $190.55 / $295.12