go back

Utah rates for HCPCS L5639

Addition To Lower Extremity Below Knee Wood Socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$433.41 / $433.41 / $433.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$433.41 / $581.30 / $5,176.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.50 / $870.50 / $870.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$635.47 / $870.50 / $1,034.53
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.10 / $1,309.84 / $1,702.80
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,571.10 / $1,752.19 / $1,752.19
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$997.77 / $1,255.98 / $1,883.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$606.16 / $671.35 / $963.13