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Utah rates for HCPCS L5830

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$733.52 / $733.52 / $733.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$733.52 / $983.83 / $8,761.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,654.54 / $1,654.54 / $1,654.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,207.81 / $1,654.54 / $1,763.81
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,030.83 / $1,662.63 / $2,161.41
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,994.26 / $2,224.12 / $2,224.12
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,266.49 / $1,594.25 / $2,391.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,025.90 / $1,136.22 / $1,630.05