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Idaho rates for HCPCS L2628

Addition To Lower Extremity Pelvic Control Metal Frame Reciprocating Hip Joint And Cables

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$743.73 / $2,203.66 / $2,203.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,179.41 / $1,179.41 / $1,183.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$860.97 / $1,179.40 / $1,214.79
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$607.91 / $1,772.73 / $2,516.63
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,264.96 / $2,390.80 / $2,516.63
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $1,880.11 / $2,264.96
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,203.66 / $2,457.65 / $3,686.48
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,761.64 / $1,761.64 / $2,642.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.62 / $941.64 / $1,681.54