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Utah rates for HCPCS L5964

Addition, endoskeletal system, above knee (AK), flexible protective outer surface covering system

Facilitymedian $708 · 10th–90th $363–$1,2590%20%40%10th90th$708Professionalmedian $912 · 10th–90th $363–$5,8880%10%10th90th$912$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$363.08 / $363.08 / $363.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $676.08 / $5,888.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $724.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $933.25 / $1,202.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,258.93 / $1,258.93
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $1,412.54
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,380.38
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,288.25 / $1,659.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $741.31 / $851.14
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $562.34 / $1,023.29