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Idaho rates for HCPCS 21175

Rcnstj Bifrontal Superior-Lat Orb Rims & Lwr Fhd

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,415.00 / $4,500.00 / $8,439.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,001.22 / $3,093.13 / $4,511.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,449.29 / $3,356.23 / $3,878.05
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,094.56 / $3,835.01 / $5,459.25
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,545.49 / $3,867.80 / $5,147.25
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $3,041.38 / $3,826.25
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,660.78 / $14,097.25 / $17,807.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,191.58 / $4,399.57 / $5,147.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,100.00 / $10,120.00 / $27,159.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,417.04 / $3,315.81 / $4,689.52