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Utah rates for HCPCS L8417

Prosthetic sheath/sock, including a gel cushion layer, below knee (BK) or above knee (AK), each

Facilitymedian $50 · 10th–90th $26–$910%20%40%10th90th$50Professionalmedian $66 · 10th–90th $26–$3890%10%10th90th$66$50.0$100.0$200.0

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
$25.70 / $25.70 / $25.70
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $47.86 / $389.05
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $50.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $37.15 / $52.48
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $67.61 / $87.10
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $91.20 / $91.20
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $66.07 / $100.00
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $91.20 / $93.33
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $93.33 / $109.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $53.70 / $60.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $40.74 / $67.61