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Idaho rates for HCPCS L5230

Above knee (AK), for proximal femoral focal deficiency, constant friction knee, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,590.53 / $4,962.60 / $5,064.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,853.06 / $2,853.06 / $3,818.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,082.73 / $2,853.06 / $2,938.65
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,470.57 / $4,212.20 / $5,903.59
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,313.23 / $5,608.41 / $5,903.59
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $4,356.84 / $5,188.70
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,169.38 / $5,765.22 / $8,647.83
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,132.51 / $4,261.53 / $6,198.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,106.10 / $2,277.89 / $3,612.72