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Utah rates for HCPCS L5816

Addition Endoskeletal Knee-Shin System Polycentric Mechanical Stance Phase Lock

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$328.75 / $328.75 / $328.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.75 / $440.94 / $3,926.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.31 / $660.31 / $660.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$482.03 / $660.31 / $784.72
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.00 / $993.56 / $1,291.62
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,191.73 / $1,329.09 / $1,329.09
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$756.83 / $952.69 / $1,429.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$459.79 / $509.24 / $730.56