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Utah rates for HCPCS L5654

Addition to lower extremity, socket insert, Symes, (Kemblo, Pelite, Aliplast, Plastazote or equal)

Facilitymedian $263 · 10th–90th $129$3980%20%40%10th90th$263Professionalmedian $288 · 10th–90th $129$2,1380%10%10th90th$288$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
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$128.82
Aetna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$239.88
Typical High
$2,137.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$309.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$223.87
Typical High
$309.03
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$295.12
Typical High
$380.19
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$380.19
Median
$398.11
Typical High
$398.11
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$446.68
Select Health
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$478.63
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$407.38
Typical High
$575.44
United
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$245.47
Typical High
$302.00
United
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$199.53
Typical High
$323.59