go back

Idaho rates for HCPCS L5100

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,029.53 / $2,818.98 / $2,818.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,743.07 / $1,743.07 / $2,023.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,272.44 / $1,272.44 / $2,929.03
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$898.44 / $2,442.62 / $3,353.50
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,018.15 / $3,185.83 / $3,353.50
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $2,474.88 / $2,947.41
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,936.44 / $3,274.90 / $4,912.35
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,347.44 / $2,347.44 / $3,521.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,286.72 / $1,391.68 / $2,240.73