go back

Idaho rates for HCPCS L5105

Below knee (BK), plastic socket, joints and thigh lacer, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,878.55 / $3,978.55 / $4,624.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,006.81 / $3,006.81 / $3,486.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,194.96 / $3,006.81 / $3,097.01
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,342.91 / $3,556.83 / $4,732.93
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,259.64 / $4,496.29 / $4,732.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $3,492.91 / $4,159.81
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,144.32 / $4,622.01 / $6,933.02
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,313.06 / $3,313.06 / $4,969.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,923.28 / $2,080.16 / $3,299.12