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Utah rates for HCPCS L5645

Addition To Lower Extremity Below Knee Flexible Inner Socket External Frame

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$308.44 / $308.44 / $308.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$308.44 / $351.21 / $3,127.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$694.09 / $694.09 / $694.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$506.69 / $694.09 / $813.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$577.93 / $932.15 / $1,211.79
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,118.08 / $1,246.96 / $1,246.96
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$710.07 / $893.82 / $1,340.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$431.38 / $477.77 / $685.42