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Utah rates for HCPCS L5858

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

Facilitymedian $14,454 · 10th–90th $6,457–$22,9090%20%40%10th90th$14,454Professionalmedian $16,218 · 10th–90th $6,457–$95,4990%10%20%10th90th$16,218$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
$6,456.54 / $6,456.54 / $6,456.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,456.54 / $12,022.64 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14,454.40 / $14,454.40 / $14,454.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,715.19 / $10,715.19 / $14,454.40
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $16,595.87 / $21,379.62
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $22,908.68 / $22,908.68
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,488.17 / $16,218.10 / $24,547.09
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21,877.62 / $22,908.68 / $22,908.68
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,218.10 / $22,908.68 / $26,915.35
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,317.64 / $13,182.57 / $15,135.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,762.47 / $10,000.00 / $16,595.87