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Utah rates for HCPCS L5856

Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type

Facilitymedian $16,218 · 10th–90th $8,318–$29,5120%20%40%10th90th$16,218Professionalmedian $20,893 · 10th–90th $8,318–$123,0270%10%20%10th90th$20,893$50.0$200.0$1.0K$5.0K$20.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,317.64 / $8,317.64 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,317.64 / $15,488.17 / $123,026.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $16,218.10
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,748.98 / $11,748.98 / $16,982.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $21,379.62 / $27,542.29
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28,183.83 / $29,512.09 / $29,512.09
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20,417.38 / $20,892.96 / $31,622.78
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28,183.83 / $29,512.09 / $30,199.52
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20,892.96 / $30,199.52 / $34,673.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,715.19 / $16,982.44 / $19,498.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,232.93 / $12,882.50 / $21,877.62