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Utah rates for HCPCS L5676

Additions to lower extremity, below knee (BK), knee joints, single axis, pair

Facilitymedian $269 · 10th–90th $141–$5370%20%40%10th90th$269Professionalmedian $363 · 10th–90th $141–$2,5120%10%10th90th$363$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
$141.25 / $141.25 / $141.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $269.15 / $2,511.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $288.40
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $389.05 / $512.86
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $537.03 / $537.03
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $380.19 / $562.34
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $537.03 / $549.54
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $549.54 / $616.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $288.40 / $323.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $218.78 / $426.58