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Utah rates for HCPCS L5677

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

Facilitymedian $398 · 10th–90th $191–$5890%20%40%10th90th$398Professionalmedian $427 · 10th–90th $191–$3,4670%10%10th90th$427$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
$190.55 / $190.55 / $190.55
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $354.81 / $3,467.37
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $398.11
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $436.52 / $562.34
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $588.84 / $588.84
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $660.69
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $660.69
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $602.56 / $794.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $398.11 / $446.68
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $295.12 / $478.63