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Utah rates for HCPCS L5812

Addition Endoskeletal Knee-Shin System Single Axis Friction Swing And Stance Phase Control (Safety Knee)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.52 / $218.52 / $218.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.52 / $293.10 / $2,610.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$472.30 / $472.30 / $472.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$344.78 / $472.30 / $503.49
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$377.75 / $609.29 / $792.07
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$730.83 / $815.06 / $815.06
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$464.13 / $584.23 / $876.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$305.63 / $338.50 / $485.61