go back

Utah rates for HCPCS L5656

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

Facilitymedian $331 · 10th–90th $145–$4570%20%40%10th90th$331Professionalmedian $331 · 10th–90th $145–$2,5700%5%10%10th90th$331$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
$144.54 / $144.54 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $269.15 / $2,570.40
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $338.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $338.84 / $436.52
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $457.09 / $457.09
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $512.86
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $602.56
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $467.74 / $691.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $295.12 / $331.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $223.87 / $371.54