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Utah rates for HCPCS L5631

Addition to lower extremity, above knee (AK) or knee disarticulation, acrylic socket

Facilitymedian $331 · 10th–90th $170–$5250%20%40%10th90th$331Professionalmedian $380 · 10th–90th $170–$2,2910%10%10th90th$380$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
$169.82 / $169.82 / $169.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $316.23 / $2,290.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $331.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $389.05 / $501.19
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $524.81 / $524.81
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $588.84
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $537.03
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $537.03 / $645.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $263.03 / $398.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $263.03 / $407.38