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Idaho rates for HCPCS L5200

Above Knee Molded Socket Single Axis Constant Friction Knee Shin Sach Foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,884.70 / $4,109.85 / $4,109.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,728.17 / $2,728.17 / $3,021.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,991.56 / $1,991.56 / $4,163.22
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,277.01 / $3,471.87 / $4,889.12
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,400.21 / $4,644.66 / $4,889.12
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $3,608.17 / $4,297.08
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,281.09 / $4,774.53 / $7,161.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,422.38 / $3,422.38 / $5,133.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,828.90 / $1,978.08 / $3,266.78