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Utah rates for HCPCS L5822

Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$658.29 / $658.29 / $658.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$658.29 / $662.19 / $5,897.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,367.82 / $1,367.82 / $1,367.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$998.51 / $1,367.82 / $1,458.16
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.17 / $1,650.29 / $2,145.37
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,979.46 / $2,207.61 / $2,207.61
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,257.09 / $1,582.41 / $2,373.62
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$849.73 / $1,347.44 / $1,359.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$920.68 / $1,019.68 / $1,462.86