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Idaho rates for HCPCS L4030

Replace quadrilateral socket brim, custom fitted

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.83 / $651.80 / $651.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$475.68 / $477.88 / $477.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$348.85 / $348.85 / $597.24
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$183.20 / $524.36 / $744.39
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$669.95 / $707.17 / $744.39
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $549.35 / $654.25
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$651.80 / $726.94 / $1,090.41
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$521.07 / $521.07 / $781.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$262.37 / $283.76 / $497.38