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Utah rates for HCPCS L5640

Addition to lower extremity, knee disarticulation, leather socket

Facilitymedian $513 · 10th–90th $245–$1,0230%20%40%10th90th$513Professionalmedian $724 · 10th–90th $245–$4,0740%10%10th90th$724$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
$245.47 / $245.47 / $245.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $512.86 / $4,073.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $588.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $741.31 / $977.24
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,023.29 / $1,023.29
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $1,122.02
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,023.29 / $1,047.13
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,047.13 / $1,230.27
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $467.74 / $575.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $380.19 / $707.95