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Idaho rates for HCPCS L5100

Below knee (BK), molded socket, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $2,041.74 / $2,818.38
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $3,162.28 / $4,897.79
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,548.13 / $3,801.89 / $3,801.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $1,737.80 / $2,041.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,258.93 / $1,737.80
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $2,691.53 / $3,467.37
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,691.53 / $3,235.94 / $3,388.44
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $2,884.03
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $3,311.31 / $3,311.31
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,398.83 / $2,398.83 / $3,801.89
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,691.53 / $3,388.44 / $3,388.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,445.44 / $1,819.70 / $2,089.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,380.38 / $2,137.96