go back

Utah rates for HCPCS L5703

Ankle Symes Molded To Patient Model Socket Without Solid Ankle Cushion Heel (Sach) Foot Replacement Only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$808.65 / $808.65 / $808.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$808.65 / $936.06 / $8,336.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,119.51 / $2,119.51 / $2,119.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,547.24 / $2,119.51 / $2,183.10
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,229.12 / $1,982.46 / $2,577.19
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,377.88 / $2,651.96 / $2,651.96
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,510.12 / $1,900.93 / $2,851.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,130.97 / $1,252.58 / $1,749.75