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Utah rates for HCPCS L5716

Addition Exoskeletal Knee-Shin System Polycentric Mechanical Stance Phase Lock

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.75 / $281.75 / $281.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.75 / $377.88 / $3,365.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$673.11 / $673.11 / $673.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$491.37 / $673.11 / $693.30
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$527.91 / $851.48 / $1,106.92
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,021.31 / $1,139.03 / $1,139.03
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$648.61 / $816.46 / $1,224.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$394.05 / $436.42 / $626.10