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Idaho rates for HCPCS L4130

Replace Pretibial Shell

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$293.66 / $652.57 / $652.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$373.57 / $373.57 / $467.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$272.70 / $373.57 / $384.78
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$180.02 / $524.96 / $745.25
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$670.73 / $707.99 / $745.25
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $549.99 / $655.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$652.57 / $727.78 / $1,091.67
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$521.67 / $521.67 / $782.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.45 / $322.27 / $364.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.82 / $278.85 / $497.96