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Utah rates for HCPCS L5950

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $302.00 / $302.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $549.54 / $4,073.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $588.84 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $426.58 / $616.60
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $707.95 / $912.01
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $851.14 / $1,479.11
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $691.83 / $1,047.13
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $977.24 / $1,071.52
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $1,000.00 / $1,318.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.05 / $467.74 / $707.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $467.74 / $691.83