go back

Idaho rates for HCPCS L2387

Addition to lower extremity, polycentric knee joint, for custom fabricated knee-ankle-foot orthosis (KAFO), each joint

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.96 / $200.34 / $200.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$116.51 / $116.51 / $155.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.05 / $85.05 / $124.20
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.05 / $161.15 / $228.79
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$205.91 / $217.35 / $228.79
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $168.84 / $201.09
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$200.34 / $223.43 / $335.15
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.15 / $160.15 / $240.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.15 / $105.48 / $108.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.00 / $93.02 / $147.52