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Utah rates for HCPCS L5702

Replacement, socket, hip disarticulation, including hip joint, molded to patient model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,679.50 / $1,679.50 / $1,679.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,679.50 / $2,252.62 / $20,060.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,745.37 / $3,745.37 / $3,745.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,734.12 / $2,734.12 / $6,779.25
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,835.82 / $4,573.91 / $5,946.08
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,486.21 / $6,118.56 / $6,118.56
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,484.12 / $4,385.79 / $6,578.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,167.94 / $2,601.52 / $3,732.22