go back

Idaho rates for HCPCS 95875

Ischemic Limb Xers Tst Spec Acquisj Metab

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.66 / $136.07 / $188.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.13 / $216.03 / $260.51
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.14 / $203.79 / $237.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $93.12 / $189.49
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.78 / $182.09 / $237.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.00 / $180.39 / $257.04