go back

Utah rates for HCPCS L5644

Addition to lower extremity, above knee (AK), wood socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $229.09 / $229.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $426.58 / $3,090.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $457.09 / $457.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $331.13 / $549.54
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $691.83 / $891.25
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $831.76 / $1,445.44
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $676.08 / $851.14
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $954.99 / $954.99
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $954.99 / $977.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $467.74 / $537.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $354.81 / $524.81