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Utah rates for HCPCS L5971

All Lower Extremity Prosthesis Solid Ankle Cushion Heel (Sach) Foot Replacement Only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.51 / $78.51 / $78.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.51 / $99.36 / $884.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$159.21 / $159.21 / $159.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.22 / $159.21 / $169.72
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.34 / $198.95 / $258.63
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$238.63 / $266.13 / $266.13
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.55 / $190.76 / $286.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.80 / $121.61 / $174.46