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Idaho rates for HCPCS L5617

Addition to lower extremity, quick change self-aligning unit, above knee (AK) or below knee (BK), each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$400.95 / $554.16 / $554.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$413.50 / $436.96 / $436.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.98 / $436.96 / $450.07
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$195.58 / $464.37 / $659.24
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.32 / $626.28 / $659.24
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $486.52 / $579.41
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$577.26 / $643.79 / $965.69
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$461.47 / $476.53 / $692.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.11 / $302.95 / $480.49