go back

Utah rates for HCPCS L5780

Addition Exoskeletal Knee-Shin System Single Axis Pneumatic/Hydra Pneumatic Swing Phase Control

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$442.58 / $442.58 / $442.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$442.58 / $593.61 / $5,286.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,036.33 / $1,036.33 / $1,036.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$756.53 / $1,036.33 / $1,067.43
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$624.37 / $1,007.05 / $1,309.16
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,207.91 / $1,347.14 / $1,347.14
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$767.11 / $965.63 / $1,448.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$619.00 / $685.56 / $983.52