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Utah rates for HCPCS L5857

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

Facilitymedian $6,607 · 10th–90th $2,951–$10,4710%20%40%10th90th$6,607Professionalmedian $7,413 · 10th–90th $2,951–$43,6520%10%10th90th$7,413$50.0$200.0$1.0K$5.0K$20.0K

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
$2,951.21 / $2,951.21 / $2,951.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $5,495.41 / $43,651.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $6,606.93 / $6,606.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,897.79 / $4,897.79 / $6,606.93
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $7,585.78 / $9,772.37
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,772.37 / $10,471.29 / $10,471.29
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,244.36 / $7,413.10 / $11,220.18
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,000.00 / $10,471.29 / $10,471.29
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,413.10 / $10,471.29 / $12,302.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,801.89 / $6,025.60 / $6,918.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,630.78 / $4,570.88 / $7,762.47