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Utah rates for HCPCS L5940

Addition, endoskeletal system, below knee (BK), ultra-light material (titanium, carbon fiber or equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$193.91 / $193.91 / $193.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$193.91 / $207.31 / $1,846.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$382.03 / $382.03 / $382.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$278.88 / $382.03 / $462.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.33 / $586.02 / $761.82
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$702.90 / $783.92 / $783.92
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.39 / $561.91 / $842.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$271.19 / $300.36 / $430.90