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Utah rates for HCPCS L5962

Addition, endoskeletal system, below knee (BK), flexible protective outer surface covering system

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$227.22 / $227.22 / $227.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$227.22 / $304.76 / $2,714.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$448.56 / $448.56 / $448.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$327.45 / $448.56 / $518.20
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$406.78 / $656.10 / $852.93
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$786.97 / $877.68 / $877.68
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$499.78 / $629.12 / $943.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$470.15 / $470.15 / $470.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.02 / $351.96 / $586.60