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Manual Lock, Above-Knee, Knee or Hip Disarticulation

Utah rates for HCPCS L5925

Addition, endoskeletal system, above knee (AK), knee disarticulation or hip disarticulation, manual lock

Rates data updated July 2026.

Facilitymedian $263 · 10th–90th $129$5370%20%40%10th90th$263Professionalmedian $288 · 10th–90th $129$2,2910%10%10th90th$288$50.0$100.0$200.0$500.0$1.0K$2.0K

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

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$128.82
Aetna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$234.42
Typical High
$2,290.87
Cigna
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$263.03
Typical High
$263.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$275.42
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$389.05
Typical High
$501.19
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$537.03
Typical High
$537.03
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$380.19
Typical High
$588.84
Select Health
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$549.54
Select Health
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$537.03
Typical High
$549.54
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$549.54
Typical High
$645.65
United
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$263.03
Typical High
$316.23
United
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$199.53
Typical High
$309.03