go back

Utah rates for HCPCS L5695

Addition to lower extremity, above knee (AK), pelvic control, sleeve suspension, neoprene or equal, each

Facilitymedian $123 · 10th–90th $63–$2400%20%40%10th90th$123Professionalmedian $162 · 10th–90th $63–$1,1220%10%20%10th90th$162$50.0$100.0$200.0$500.0$1.0K

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
$63.10 / $63.10 / $63.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $117.49 / $1,122.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $131.83
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $173.78 / $223.87
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $239.88 / $239.88
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $169.82 / $218.78
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $239.88 / $245.47
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $245.47 / $245.47
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $128.82 / $147.91
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $97.72 / $190.55