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Utah rates for HCPCS L5639

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

Facilitymedian $871 · 10th–90th $437–$1,7780%20%40%10th90th$871Professionalmedian $1,122 · 10th–90th $437–$7,7620%10%10th90th$1,122$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$436.52 / $436.52 / $436.52
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $891.25 / $7,762.47
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $870.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $891.25
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $1,318.26 / $1,698.24
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,778.28 / $1,778.28
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,288.25 / $1,698.24
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,778.28 / $1,819.70
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,819.70 / $1,862.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $891.25 / $1,513.56
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $676.08 / $1,318.26